|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,874.00
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
44140
|
| Min. Negotiated Rate |
$1,299.60 |
| Max. Negotiated Rate |
$2,518.10 |
| Rate for Payer: Aetna Commercial |
$1,741.46
|
| Rate for Payer: Aetna Medicare |
$1,299.60
|
| Rate for Payer: BCBS Complete |
$1,549.60
|
| Rate for Payer: BCBS MAPPO |
$1,299.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.60
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$1,871.42
|
| Rate for Payer: Cofinity Commercial |
$1,741.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.60
|
| Rate for Payer: Healthscope Commercial |
$1,559.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,559.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.58
|
| Rate for Payer: Nomi Health Commercial |
$1,559.52
|
| Rate for Payer: PACE SWMI |
$1,299.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health Medicare |
$1,299.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.60
|
| Rate for Payer: UHCCP DNSP |
$1,299.60
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Facility
|
IP
|
$3,874.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
44140
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$2,518.10 |
| Max. Negotiated Rate |
$3,874.00 |
| Rate for Payer: Aetna Commercial |
$3,486.60
|
| Rate for Payer: ASR ASR |
$3,757.78
|
| Rate for Payer: ASR Commercial |
$3,757.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,156.92
|
| Rate for Payer: BCN Commercial |
$3,003.51
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$3,641.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,099.20
|
| Rate for Payer: Healthscope Commercial |
$3,874.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,757.78
|
| Rate for Payer: Mclaren Commercial |
$3,486.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,292.90
|
| Rate for Payer: Nomi Health Commercial |
$3,176.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,409.12
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Facility
|
OP
|
$3,874.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
44140
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,549.60 |
| Max. Negotiated Rate |
$3,874.00 |
| Rate for Payer: Aetna Commercial |
$3,486.60
|
| Rate for Payer: Aetna Medicare |
$1,937.00
|
| Rate for Payer: ASR ASR |
$3,757.78
|
| Rate for Payer: ASR Commercial |
$3,757.78
|
| Rate for Payer: BCBS Complete |
$1,549.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,172.42
|
| Rate for Payer: BCN Commercial |
$3,003.51
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$3,641.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,099.20
|
| Rate for Payer: Healthscope Commercial |
$3,874.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,757.78
|
| Rate for Payer: Mclaren Commercial |
$3,486.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,292.90
|
| Rate for Payer: Nomi Health Commercial |
$3,176.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,394.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,715.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,409.12
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$3,874.00
|
|
|
Service Code
|
HCPCS 44140
|
| Min. Negotiated Rate |
$1,299.60 |
| Max. Negotiated Rate |
$2,518.10 |
| Rate for Payer: Aetna Commercial |
$1,741.46
|
| Rate for Payer: Aetna Medicare |
$1,299.60
|
| Rate for Payer: BCBS Complete |
$1,549.60
|
| Rate for Payer: BCBS MAPPO |
$1,299.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.60
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cash Price |
$3,099.20
|
| Rate for Payer: Cofinity Commercial |
$1,871.42
|
| Rate for Payer: Cofinity Commercial |
$1,741.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.60
|
| Rate for Payer: Healthscope Commercial |
$1,559.52
|
| Rate for Payer: Healthscope Whirlpool |
$1,559.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,364.58
|
| Rate for Payer: Nomi Health Commercial |
$1,559.52
|
| Rate for Payer: PACE SWMI |
$1,299.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,518.10
|
| Rate for Payer: Priority Health Medicare |
$1,299.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,299.60
|
| Rate for Payer: UHCCP DNSP |
$1,299.60
|
|
|
PR COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH
|
Professional
|
Both
|
$2,752.00
|
|
|
Service Code
|
HCPCS 44147
|
| Min. Negotiated Rate |
$1,100.80 |
| Max. Negotiated Rate |
$2,695.08 |
| Rate for Payer: Aetna Commercial |
$2,507.92
|
| Rate for Payer: Aetna Medicare |
$1,871.58
|
| Rate for Payer: BCBS Complete |
$1,100.80
|
| Rate for Payer: BCBS MAPPO |
$1,871.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,871.58
|
| Rate for Payer: Cash Price |
$2,201.60
|
| Rate for Payer: Cash Price |
$2,201.60
|
| Rate for Payer: Cofinity Commercial |
$2,695.08
|
| Rate for Payer: Cofinity Commercial |
$2,507.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,871.58
|
| Rate for Payer: Healthscope Commercial |
$2,245.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,245.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,965.16
|
| Rate for Payer: Nomi Health Commercial |
$2,245.90
|
| Rate for Payer: PACE SWMI |
$1,871.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,871.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,788.80
|
| Rate for Payer: Priority Health Medicare |
$1,871.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,871.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,871.58
|
| Rate for Payer: UHCCP DNSP |
$1,871.58
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY
|
Professional
|
Both
|
$3,419.00
|
|
|
Service Code
|
HCPCS 44145
|
| Min. Negotiated Rate |
$1,367.60 |
| Max. Negotiated Rate |
$2,287.92 |
| Rate for Payer: Aetna Commercial |
$2,129.03
|
| Rate for Payer: Aetna Medicare |
$1,588.83
|
| Rate for Payer: BCBS Complete |
$1,367.60
|
| Rate for Payer: BCBS MAPPO |
$1,588.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,588.83
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cofinity Commercial |
$2,287.92
|
| Rate for Payer: Cofinity Commercial |
$2,129.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,588.83
|
| Rate for Payer: Healthscope Commercial |
$1,906.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,906.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,668.27
|
| Rate for Payer: Nomi Health Commercial |
$1,906.60
|
| Rate for Payer: PACE SWMI |
$1,588.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,588.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,222.35
|
| Rate for Payer: Priority Health Medicare |
$1,588.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,588.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,588.83
|
| Rate for Payer: UHCCP DNSP |
$1,588.83
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY
|
Professional
|
Both
|
$5,145.00
|
|
|
Service Code
|
HCPCS 44146
|
| Min. Negotiated Rate |
$2,017.07 |
| Max. Negotiated Rate |
$3,344.25 |
| Rate for Payer: Aetna Commercial |
$2,702.87
|
| Rate for Payer: Aetna Medicare |
$2,017.07
|
| Rate for Payer: BCBS Complete |
$2,058.00
|
| Rate for Payer: BCBS MAPPO |
$2,017.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,017.07
|
| Rate for Payer: Cash Price |
$4,116.00
|
| Rate for Payer: Cash Price |
$4,116.00
|
| Rate for Payer: Cofinity Commercial |
$2,904.58
|
| Rate for Payer: Cofinity Commercial |
$2,702.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,017.07
|
| Rate for Payer: Healthscope Commercial |
$2,420.48
|
| Rate for Payer: Healthscope Whirlpool |
$2,420.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,117.92
|
| Rate for Payer: Nomi Health Commercial |
$2,420.48
|
| Rate for Payer: PACE SWMI |
$2,017.07
|
| Rate for Payer: PHP Medicare Advantage |
$2,017.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,344.25
|
| Rate for Payer: Priority Health Medicare |
$2,017.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,017.07
|
| Rate for Payer: UHC Medicare Advantage |
$2,017.07
|
| Rate for Payer: UHCCP DNSP |
$2,017.07
|
|
|
PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA
|
Professional
|
Both
|
$3,983.00
|
|
|
Service Code
|
HCPCS 44144
|
| Min. Negotiated Rate |
$1,593.20 |
| Max. Negotiated Rate |
$2,588.95 |
| Rate for Payer: Aetna Commercial |
$2,280.83
|
| Rate for Payer: Aetna Medicare |
$1,702.11
|
| Rate for Payer: BCBS Complete |
$1,593.20
|
| Rate for Payer: BCBS MAPPO |
$1,702.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,702.11
|
| Rate for Payer: Cash Price |
$3,186.40
|
| Rate for Payer: Cash Price |
$3,186.40
|
| Rate for Payer: Cofinity Commercial |
$2,451.04
|
| Rate for Payer: Cofinity Commercial |
$2,280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,702.11
|
| Rate for Payer: Healthscope Commercial |
$2,042.53
|
| Rate for Payer: Healthscope Whirlpool |
$2,042.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,787.22
|
| Rate for Payer: Nomi Health Commercial |
$2,042.53
|
| Rate for Payer: PACE SWMI |
$1,702.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,702.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.95
|
| Rate for Payer: Priority Health Medicare |
$1,702.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,702.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,702.11
|
| Rate for Payer: UHCCP DNSP |
$1,702.11
|
|
|
PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT
|
Professional
|
Both
|
$4,200.00
|
|
|
Service Code
|
HCPCS 44143
|
| Min. Negotiated Rate |
$1,593.57 |
| Max. Negotiated Rate |
$2,730.00 |
| Rate for Payer: Aetna Commercial |
$2,135.38
|
| Rate for Payer: Aetna Medicare |
$1,593.57
|
| Rate for Payer: BCBS Complete |
$1,680.00
|
| Rate for Payer: BCBS MAPPO |
$1,593.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,593.57
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Cash Price |
$3,360.00
|
| Rate for Payer: Cofinity Commercial |
$2,294.74
|
| Rate for Payer: Cofinity Commercial |
$2,135.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,593.57
|
| Rate for Payer: Healthscope Commercial |
$1,912.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,912.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,673.25
|
| Rate for Payer: Nomi Health Commercial |
$1,912.28
|
| Rate for Payer: PACE SWMI |
$1,593.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,593.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: Priority Health Medicare |
$1,593.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,593.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,593.57
|
| Rate for Payer: UHCCP DNSP |
$1,593.57
|
|
|
PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS
|
Professional
|
Both
|
$3,965.00
|
|
|
Service Code
|
HCPCS 44160
|
| Min. Negotiated Rate |
$1,201.94 |
| Max. Negotiated Rate |
$2,577.25 |
| Rate for Payer: Aetna Commercial |
$1,610.60
|
| Rate for Payer: Aetna Medicare |
$1,201.94
|
| Rate for Payer: BCBS Complete |
$1,586.00
|
| Rate for Payer: BCBS MAPPO |
$1,201.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,201.94
|
| Rate for Payer: Cash Price |
$3,172.00
|
| Rate for Payer: Cash Price |
$3,172.00
|
| Rate for Payer: Cofinity Commercial |
$1,730.79
|
| Rate for Payer: Cofinity Commercial |
$1,610.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,201.94
|
| Rate for Payer: Healthscope Commercial |
$1,442.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,442.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,262.04
|
| Rate for Payer: Nomi Health Commercial |
$1,442.33
|
| Rate for Payer: PACE SWMI |
$1,201.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,201.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,577.25
|
| Rate for Payer: Priority Health Medicare |
$1,201.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,201.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,201.94
|
| Rate for Payer: UHCCP DNSP |
$1,201.94
|
|
|
PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY
|
Professional
|
Both
|
$3,835.00
|
|
|
Service Code
|
HCPCS 44141
|
| Min. Negotiated Rate |
$1,534.00 |
| Max. Negotiated Rate |
$2,511.43 |
| Rate for Payer: Aetna Commercial |
$2,337.03
|
| Rate for Payer: Aetna Medicare |
$1,744.05
|
| Rate for Payer: BCBS Complete |
$1,534.00
|
| Rate for Payer: BCBS MAPPO |
$1,744.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,744.05
|
| Rate for Payer: Cash Price |
$3,068.00
|
| Rate for Payer: Cash Price |
$3,068.00
|
| Rate for Payer: Cofinity Commercial |
$2,511.43
|
| Rate for Payer: Cofinity Commercial |
$2,337.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,744.05
|
| Rate for Payer: Healthscope Commercial |
$2,092.86
|
| Rate for Payer: Healthscope Whirlpool |
$2,092.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,831.25
|
| Rate for Payer: Nomi Health Commercial |
$2,092.86
|
| Rate for Payer: PACE SWMI |
$1,744.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,744.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,492.75
|
| Rate for Payer: Priority Health Medicare |
$1,744.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,744.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,744.05
|
| Rate for Payer: UHCCP DNSP |
$1,744.05
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST
|
Professional
|
Both
|
$6,820.00
|
|
|
Service Code
|
HCPCS 44156
|
| Min. Negotiated Rate |
$2,219.78 |
| Max. Negotiated Rate |
$4,433.00 |
| Rate for Payer: Aetna Commercial |
$2,974.51
|
| Rate for Payer: Aetna Medicare |
$2,219.78
|
| Rate for Payer: BCBS Complete |
$2,728.00
|
| Rate for Payer: BCBS MAPPO |
$2,219.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,219.78
|
| Rate for Payer: Cash Price |
$5,456.00
|
| Rate for Payer: Cash Price |
$5,456.00
|
| Rate for Payer: Cofinity Commercial |
$3,196.48
|
| Rate for Payer: Cofinity Commercial |
$2,974.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,219.78
|
| Rate for Payer: Healthscope Commercial |
$2,663.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,663.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,330.77
|
| Rate for Payer: Nomi Health Commercial |
$2,663.74
|
| Rate for Payer: PACE SWMI |
$2,219.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,219.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,433.00
|
| Rate for Payer: Priority Health Medicare |
$2,219.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,219.78
|
| Rate for Payer: UHC Medicare Advantage |
$2,219.78
|
| Rate for Payer: UHCCP DNSP |
$2,219.78
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$5,822.00
|
|
|
Service Code
|
HCPCS 44155
|
| Min. Negotiated Rate |
$1,979.09 |
| Max. Negotiated Rate |
$3,784.30 |
| Rate for Payer: Aetna Commercial |
$2,651.98
|
| Rate for Payer: Aetna Medicare |
$1,979.09
|
| Rate for Payer: BCBS Complete |
$2,328.80
|
| Rate for Payer: BCBS MAPPO |
$1,979.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,979.09
|
| Rate for Payer: Cash Price |
$4,657.60
|
| Rate for Payer: Cash Price |
$4,657.60
|
| Rate for Payer: Cofinity Commercial |
$2,849.89
|
| Rate for Payer: Cofinity Commercial |
$2,651.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,979.09
|
| Rate for Payer: Healthscope Commercial |
$2,374.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,374.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,078.04
|
| Rate for Payer: Nomi Health Commercial |
$2,374.91
|
| Rate for Payer: PACE SWMI |
$1,979.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,979.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,784.30
|
| Rate for Payer: Priority Health Medicare |
$1,979.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,979.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,979.09
|
| Rate for Payer: UHCCP DNSP |
$1,979.09
|
|
|
PR COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST
|
Professional
|
Both
|
$4,567.00
|
|
|
Service Code
|
HCPCS 44157
|
| Min. Negotiated Rate |
$1,826.80 |
| Max. Negotiated Rate |
$3,042.26 |
| Rate for Payer: Aetna Commercial |
$2,830.99
|
| Rate for Payer: Aetna Medicare |
$2,112.68
|
| Rate for Payer: BCBS Complete |
$1,826.80
|
| Rate for Payer: BCBS MAPPO |
$2,112.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,112.68
|
| Rate for Payer: Cash Price |
$3,653.60
|
| Rate for Payer: Cash Price |
$3,653.60
|
| Rate for Payer: Cofinity Commercial |
$3,042.26
|
| Rate for Payer: Cofinity Commercial |
$2,830.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,112.68
|
| Rate for Payer: Healthscope Commercial |
$2,535.22
|
| Rate for Payer: Healthscope Whirlpool |
$2,535.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,218.31
|
| Rate for Payer: Nomi Health Commercial |
$2,535.22
|
| Rate for Payer: PACE SWMI |
$2,112.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,968.55
|
| Rate for Payer: Priority Health Medicare |
$2,112.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,112.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,112.68
|
| Rate for Payer: UHCCP DNSP |
$2,112.68
|
|
|
PR COLLAGENASE, CLOST HIST INJ
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS J0775
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$109.31 |
| Rate for Payer: Aetna Commercial |
$101.72
|
| Rate for Payer: Aetna Medicare |
$75.91
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$75.91
|
| Rate for Payer: BCN Medicare Advantage |
$75.91
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$109.31
|
| Rate for Payer: Cofinity Commercial |
$101.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.91
|
| Rate for Payer: Healthscope Commercial |
$91.09
|
| Rate for Payer: Healthscope Whirlpool |
$91.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.71
|
| Rate for Payer: Nomi Health Commercial |
$91.09
|
| Rate for Payer: PACE SWMI |
$75.91
|
| Rate for Payer: PHP Medicare Advantage |
$75.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health Medicare |
$75.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.91
|
| Rate for Payer: UHC Medicare Advantage |
$75.91
|
| Rate for Payer: UHCCP DNSP |
$75.91
|
|
|
PR COLLECT BLOOD FROM CATHETER VENOUS NOS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 36592
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$40.95 |
| Rate for Payer: Aetna Commercial |
$35.26
|
| Rate for Payer: Aetna Medicare |
$26.31
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$26.31
|
| Rate for Payer: BCN Medicare Advantage |
$26.31
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Cofinity Commercial |
$35.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.31
|
| Rate for Payer: Healthscope Commercial |
$31.57
|
| Rate for Payer: Healthscope Whirlpool |
$31.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.63
|
| Rate for Payer: Nomi Health Commercial |
$31.57
|
| Rate for Payer: PACE SWMI |
$26.31
|
| Rate for Payer: PHP Medicare Advantage |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Medicare |
$26.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.31
|
| Rate for Payer: UHC Medicare Advantage |
$26.31
|
| Rate for Payer: UHCCP DNSP |
$26.31
|
|
|
PR COLLECTION CAPILLARY BLOOD SPECIMEN
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 36416
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
|
|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$13.09 |
| Rate for Payer: Aetna Commercial |
$12.18
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$9.09
|
| Rate for Payer: BCN Medicare Advantage |
$9.09
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$13.09
|
| Rate for Payer: Cofinity Commercial |
$12.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.09
|
| Rate for Payer: Healthscope Commercial |
$10.91
|
| Rate for Payer: Healthscope Whirlpool |
$10.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$10.91
|
| Rate for Payer: PACE SWMI |
$9.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$9.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.09
|
| Rate for Payer: UHC Medicare Advantage |
$9.09
|
| Rate for Payer: UHCCP DNSP |
$9.09
|
|
|
PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 99091
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$76.05 |
| Rate for Payer: Aetna Commercial |
$68.22
|
| Rate for Payer: Aetna Medicare |
$50.91
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$50.91
|
| Rate for Payer: BCN Medicare Advantage |
$50.91
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$73.31
|
| Rate for Payer: Cofinity Commercial |
$68.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.91
|
| Rate for Payer: Healthscope Commercial |
$61.09
|
| Rate for Payer: Healthscope Whirlpool |
$61.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.46
|
| Rate for Payer: Nomi Health Commercial |
$61.09
|
| Rate for Payer: PACE SWMI |
$50.91
|
| Rate for Payer: PHP Medicare Advantage |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Medicare |
$50.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.91
|
| Rate for Payer: UHC Medicare Advantage |
$50.91
|
| Rate for Payer: UHCCP DNSP |
$50.91
|
|
|
PR COLON CA SCREEN;BARIUM ENEMA
|
Professional
|
Both
|
$629.00
|
|
|
Service Code
|
HCPCS G0106
|
| Min. Negotiated Rate |
$251.60 |
| Max. Negotiated Rate |
$408.85 |
| Rate for Payer: Aetna Medicare |
$314.50
|
| Rate for Payer: BCBS Complete |
$251.60
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.85
|
|
|
PR COLON CA SCRN; BARIUM ENEMA
|
Professional
|
Both
|
$399.00
|
|
|
Service Code
|
HCPCS G0120
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$259.35 |
| Rate for Payer: Aetna Medicare |
$199.50
|
| Rate for Payer: BCBS Complete |
$159.60
|
| Rate for Payer: Cash Price |
$319.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.35
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$476.60 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$1,066.50
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$1,149.45
|
| Rate for Payer: ASR Commercial |
$1,149.45
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$970.40
|
| Rate for Payer: BCN Commercial |
$918.73
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$1,185.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$1,066.50
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.30
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$830.68
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$770.25 |
| Max. Negotiated Rate |
$1,185.00 |
| Rate for Payer: Aetna Commercial |
$1,066.50
|
| Rate for Payer: ASR ASR |
$1,149.45
|
| Rate for Payer: ASR Commercial |
$1,149.45
|
| Rate for Payer: BCBS Trust/PPO |
$965.66
|
| Rate for Payer: BCN Commercial |
$918.73
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Healthscope Commercial |
$1,185.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.45
|
| Rate for Payer: Mclaren Commercial |
$1,066.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.80
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0121
|
| Hospital Charge Code |
G0121
|
| Min. Negotiated Rate |
$174.89 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$174.89
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$174.89
|
| Rate for Payer: BCN Medicare Advantage |
$174.89
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$251.84
|
| Rate for Payer: Cofinity Commercial |
$234.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.89
|
| Rate for Payer: Healthscope Commercial |
$209.87
|
| Rate for Payer: Healthscope Whirlpool |
$209.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.63
|
| Rate for Payer: Nomi Health Commercial |
$209.87
|
| Rate for Payer: PACE SWMI |
$174.89
|
| Rate for Payer: PHP Medicare Advantage |
$174.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$174.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.89
|
| Rate for Payer: UHC Medicare Advantage |
$174.89
|
| Rate for Payer: UHCCP DNSP |
$174.89
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0121
|
| Min. Negotiated Rate |
$174.89 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$174.89
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$174.89
|
| Rate for Payer: BCN Medicare Advantage |
$174.89
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$251.84
|
| Rate for Payer: Cofinity Commercial |
$234.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.89
|
| Rate for Payer: Healthscope Commercial |
$209.87
|
| Rate for Payer: Healthscope Whirlpool |
$209.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.63
|
| Rate for Payer: Nomi Health Commercial |
$209.87
|
| Rate for Payer: PACE SWMI |
$174.89
|
| Rate for Payer: PHP Medicare Advantage |
$174.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$174.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.89
|
| Rate for Payer: UHC Medicare Advantage |
$174.89
|
| Rate for Payer: UHCCP DNSP |
$174.89
|
|
