|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Facility
|
IP
|
$1,313.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
45398
|
| Min. Negotiated Rate |
$853.45 |
| Max. Negotiated Rate |
$1,313.00 |
| Rate for Payer: Aetna Commercial |
$1,181.70
|
| Rate for Payer: ASR ASR |
$1,273.61
|
| Rate for Payer: ASR Commercial |
$1,273.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,069.96
|
| Rate for Payer: BCN Commercial |
$1,017.97
|
| Rate for Payer: Cash Price |
$1,050.40
|
| Rate for Payer: Cofinity Commercial |
$1,234.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.40
|
| Rate for Payer: Healthscope Commercial |
$1,313.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,273.61
|
| Rate for Payer: Mclaren Commercial |
$1,181.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,116.05
|
| Rate for Payer: Nomi Health Commercial |
$1,076.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,155.44
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$812.00
|
|
|
Service Code
|
HCPCS 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$158.05 |
| Max. Negotiated Rate |
$527.80 |
| Rate for Payer: Aetna Commercial |
$337.78
|
| Rate for Payer: Aetna Medicare |
$406.00
|
| Rate for Payer: BCBS Complete |
$165.95
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$360.65
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Meridian Medicaid |
$165.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.08
|
| Rate for Payer: Priority Health Narrow Network |
$442.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.31
|
| Rate for Payer: UHC Exchange |
$348.31
|
| Rate for Payer: UHCCP Medicaid |
$158.05
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
IP
|
$812.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$527.80 |
| Max. Negotiated Rate |
$812.00 |
| Rate for Payer: Aetna Commercial |
$730.80
|
| Rate for Payer: ASR ASR |
$787.64
|
| Rate for Payer: ASR Commercial |
$787.64
|
| Rate for Payer: BCBS Trust/PPO |
$661.70
|
| Rate for Payer: BCN Commercial |
$629.54
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cofinity Commercial |
$763.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.60
|
| Rate for Payer: Healthscope Commercial |
$812.00
|
| Rate for Payer: Healthscope Whirlpool |
$787.64
|
| Rate for Payer: Mclaren Commercial |
$730.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.20
|
| Rate for Payer: Nomi Health Commercial |
$665.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$714.56
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
OP
|
$812.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
45393
|
| Min. Negotiated Rate |
$527.80 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$730.80
|
| Rate for Payer: Aetna Medicare |
$1,155.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: ASR ASR |
$787.64
|
| Rate for Payer: ASR Commercial |
$787.64
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$664.95
|
| Rate for Payer: BCN Commercial |
$629.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cofinity Commercial |
$763.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$649.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$812.00
|
| Rate for Payer: Healthscope Whirlpool |
$787.64
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$730.80
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.20
|
| Rate for Payer: Nomi Health Commercial |
$665.84
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,270.76
|
| Rate for Payer: PHP Medicaid |
$619.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$711.47
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$569.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$714.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$1,790.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP DNSP |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$812.00
|
|
|
Service Code
|
HCPCS 45393
|
| Min. Negotiated Rate |
$158.05 |
| Max. Negotiated Rate |
$527.80 |
| Rate for Payer: Aetna Commercial |
$337.78
|
| Rate for Payer: Aetna Medicare |
$406.00
|
| Rate for Payer: BCBS Complete |
$165.95
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$360.65
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Cash Price |
$649.60
|
| Rate for Payer: Meridian Medicaid |
$165.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.08
|
| Rate for Payer: Priority Health Narrow Network |
$442.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.31
|
| Rate for Payer: UHC Exchange |
$348.31
|
| Rate for Payer: UHCCP Medicaid |
$158.05
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
OP
|
$1,584.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$619.21 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$1,425.60
|
| Rate for Payer: Aetna Medicare |
$1,155.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: ASR ASR |
$1,536.48
|
| Rate for Payer: ASR Commercial |
$1,536.48
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,297.14
|
| Rate for Payer: BCN Commercial |
$1,228.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,488.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,267.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,584.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,536.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$1,425.60
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,346.40
|
| Rate for Payer: Nomi Health Commercial |
$1,298.88
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,270.76
|
| Rate for Payer: PHP Medicaid |
$619.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,387.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$1,110.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,393.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$1,790.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP DNSP |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Facility
|
IP
|
$1,584.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$1,029.60 |
| Max. Negotiated Rate |
$1,584.00 |
| Rate for Payer: Aetna Commercial |
$1,425.60
|
| Rate for Payer: ASR ASR |
$1,536.48
|
| Rate for Payer: ASR Commercial |
$1,536.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.80
|
| Rate for Payer: BCN Commercial |
$1,228.08
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$1,488.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,267.20
|
| Rate for Payer: Healthscope Commercial |
$1,584.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,536.48
|
| Rate for Payer: Mclaren Commercial |
$1,425.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,346.40
|
| Rate for Payer: Nomi Health Commercial |
$1,298.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,393.92
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 45388
|
| Min. Negotiated Rate |
$170.19 |
| Max. Negotiated Rate |
$3,627.94 |
| Rate for Payer: Aetna Commercial |
$360.51
|
| Rate for Payer: Aetna Medicare |
$792.00
|
| Rate for Payer: BCBS Complete |
$178.70
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: BCN Commercial |
$3,627.94
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Meridian Medicaid |
$178.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.48
|
| Rate for Payer: Priority Health Narrow Network |
$475.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.93
|
| Rate for Payer: UHC Exchange |
$421.93
|
| Rate for Payer: UHCCP Medicaid |
$170.19
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
45388
|
| Min. Negotiated Rate |
$170.19 |
| Max. Negotiated Rate |
$3,627.94 |
| Rate for Payer: Aetna Commercial |
$360.51
|
| Rate for Payer: Aetna Medicare |
$792.00
|
| Rate for Payer: BCBS Complete |
$178.70
|
| Rate for Payer: BCBS Trust/PPO |
$339.70
|
| Rate for Payer: BCN Commercial |
$3,627.94
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Meridian Medicaid |
$178.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.48
|
| Rate for Payer: Priority Health Narrow Network |
$475.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$421.93
|
| Rate for Payer: UHC Exchange |
$421.93
|
| Rate for Payer: UHCCP Medicaid |
$170.19
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$664.30 |
| Max. Negotiated Rate |
$1,022.00 |
| Rate for Payer: Aetna Commercial |
$919.80
|
| Rate for Payer: ASR ASR |
$991.34
|
| Rate for Payer: ASR Commercial |
$991.34
|
| Rate for Payer: BCBS Trust/PPO |
$832.83
|
| Rate for Payer: BCN Commercial |
$792.36
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$960.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$1,022.00
|
| Rate for Payer: Healthscope Whirlpool |
$991.34
|
| Rate for Payer: Mclaren Commercial |
$919.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.36
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
45378
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$246.71
|
| Rate for Payer: Aetna Medicare |
$511.00
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS Trust/PPO |
$392.53
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.15
|
| Rate for Payer: Priority Health Narrow Network |
$325.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.24
|
| Rate for Payer: UHC Exchange |
$272.24
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45378
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$246.71
|
| Rate for Payer: Aetna Medicare |
$511.00
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS Trust/PPO |
$392.53
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.15
|
| Rate for Payer: Priority Health Narrow Network |
$325.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.24
|
| Rate for Payer: UHC Exchange |
$272.24
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
45378
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$1,384.58 |
| Rate for Payer: Aetna Commercial |
$919.80
|
| Rate for Payer: Aetna Medicare |
$893.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: ASR ASR |
$991.34
|
| Rate for Payer: ASR Commercial |
$991.34
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$836.92
|
| Rate for Payer: BCN Commercial |
$792.36
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$960.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$1,022.00
|
| Rate for Payer: Healthscope Whirlpool |
$991.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$893.28
|
| Rate for Payer: Mclaren Commercial |
$919.80
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Commercial |
$982.61
|
| Rate for Payer: PHP Medicaid |
$478.80
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$895.48
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$716.42
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$1,384.58
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP DNSP |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: VA VA |
$893.28
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
45390
|
| Min. Negotiated Rate |
$664.30 |
| Max. Negotiated Rate |
$1,022.00 |
| Rate for Payer: Aetna Commercial |
$919.80
|
| Rate for Payer: ASR ASR |
$991.34
|
| Rate for Payer: ASR Commercial |
$991.34
|
| Rate for Payer: BCBS Trust/PPO |
$832.83
|
| Rate for Payer: BCN Commercial |
$792.36
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$960.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$1,022.00
|
| Rate for Payer: Healthscope Whirlpool |
$991.34
|
| Rate for Payer: Mclaren Commercial |
$919.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.36
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
45390
|
| Min. Negotiated Rate |
$664.30 |
| Max. Negotiated Rate |
$4,164.76 |
| Rate for Payer: Aetna Commercial |
$919.80
|
| Rate for Payer: Aetna Medicare |
$2,686.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: ASR ASR |
$991.34
|
| Rate for Payer: ASR Commercial |
$991.34
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$836.92
|
| Rate for Payer: BCN Commercial |
$792.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$960.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$1,022.00
|
| Rate for Payer: Healthscope Whirlpool |
$991.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,686.94
|
| Rate for Payer: Mclaren Commercial |
$919.80
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$2,955.63
|
| Rate for Payer: PHP Medicaid |
$1,440.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$895.48
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$716.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$4,164.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP DNSP |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45390
|
| Min. Negotiated Rate |
$102.49 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$441.91
|
| Rate for Payer: Aetna Medicare |
$511.00
|
| Rate for Payer: BCBS Complete |
$219.18
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: BCN Commercial |
$475.97
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Meridian Medicaid |
$219.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.06
|
| Rate for Payer: Priority Health Narrow Network |
$584.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.18
|
| Rate for Payer: UHC Exchange |
$455.18
|
| Rate for Payer: UHCCP Medicaid |
$208.74
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 45390
|
| Hospital Charge Code |
45390
|
| Min. Negotiated Rate |
$102.49 |
| Max. Negotiated Rate |
$664.30 |
| Rate for Payer: Aetna Commercial |
$441.91
|
| Rate for Payer: Aetna Medicare |
$511.00
|
| Rate for Payer: BCBS Complete |
$219.18
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: BCN Commercial |
$475.97
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Meridian Medicaid |
$219.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.06
|
| Rate for Payer: Priority Health Narrow Network |
$584.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$455.18
|
| Rate for Payer: UHC Exchange |
$455.18
|
| Rate for Payer: UHCCP Medicaid |
$208.74
|
|
|
PR COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT
|
Professional
|
Both
|
$880.00
|
|
|
Service Code
|
HCPCS 45389
|
| Min. Negotiated Rate |
$181.90 |
| Max. Negotiated Rate |
$572.00 |
| Rate for Payer: Aetna Commercial |
$385.62
|
| Rate for Payer: Aetna Medicare |
$440.00
|
| Rate for Payer: BCBS Complete |
$191.00
|
| Rate for Payer: BCBS Trust/PPO |
$376.68
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: Cash Price |
$704.00
|
| Rate for Payer: Cash Price |
$704.00
|
| Rate for Payer: Meridian Medicaid |
$191.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.89
|
| Rate for Payer: Priority Health Narrow Network |
$508.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$433.85
|
| Rate for Payer: UHC Exchange |
$433.85
|
| Rate for Payer: UHCCP Medicaid |
$181.90
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$1,192.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
45379
|
| Min. Negotiated Rate |
$150.17 |
| Max. Negotiated Rate |
$774.80 |
| Rate for Payer: Aetna Commercial |
$317.33
|
| Rate for Payer: Aetna Medicare |
$596.00
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS Trust/PPO |
$260.98
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Meridian Medicaid |
$157.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.40
|
| Rate for Payer: Priority Health Narrow Network |
$419.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.15
|
| Rate for Payer: UHC Exchange |
$340.15
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Facility
|
OP
|
$1,192.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
45379
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$619.21 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$1,072.80
|
| Rate for Payer: Aetna Medicare |
$1,155.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: ASR ASR |
$1,156.24
|
| Rate for Payer: ASR Commercial |
$1,156.24
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$976.13
|
| Rate for Payer: BCN Commercial |
$924.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cofinity Commercial |
$1,120.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$953.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,192.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,156.24
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$1,072.80
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,013.20
|
| Rate for Payer: Nomi Health Commercial |
$977.44
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,270.76
|
| Rate for Payer: PHP Medicaid |
$619.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,044.43
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$835.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,048.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$1,790.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP DNSP |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: VA VA |
$1,155.24
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Facility
|
IP
|
$1,192.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
45379
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$774.80 |
| Max. Negotiated Rate |
$1,192.00 |
| Rate for Payer: Aetna Commercial |
$1,072.80
|
| Rate for Payer: ASR ASR |
$1,156.24
|
| Rate for Payer: ASR Commercial |
$1,156.24
|
| Rate for Payer: BCBS Trust/PPO |
$971.36
|
| Rate for Payer: BCN Commercial |
$924.16
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cofinity Commercial |
$1,120.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$953.60
|
| Rate for Payer: Healthscope Commercial |
$1,192.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,156.24
|
| Rate for Payer: Mclaren Commercial |
$1,072.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,013.20
|
| Rate for Payer: Nomi Health Commercial |
$977.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,048.96
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$1,192.00
|
|
|
Service Code
|
HCPCS 45379
|
| Min. Negotiated Rate |
$150.17 |
| Max. Negotiated Rate |
$774.80 |
| Rate for Payer: Aetna Commercial |
$317.33
|
| Rate for Payer: Aetna Medicare |
$596.00
|
| Rate for Payer: BCBS Complete |
$157.68
|
| Rate for Payer: BCBS Trust/PPO |
$260.98
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Cash Price |
$953.60
|
| Rate for Payer: Meridian Medicaid |
$157.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$774.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.40
|
| Rate for Payer: Priority Health Narrow Network |
$419.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.15
|
| Rate for Payer: UHC Exchange |
$340.15
|
| Rate for Payer: UHCCP Medicaid |
$150.17
|
|
|
PR COLONOSCOPY STOMA ABLATION LESION
|
Professional
|
Both
|
$1,217.00
|
|
|
Service Code
|
HCPCS 44401
|
| Min. Negotiated Rate |
$152.30 |
| Max. Negotiated Rate |
$3,510.17 |
| Rate for Payer: Aetna Commercial |
$321.78
|
| Rate for Payer: Aetna Medicare |
$608.50
|
| Rate for Payer: BCBS Complete |
$159.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,324.06
|
| Rate for Payer: BCN Commercial |
$3,510.17
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Cash Price |
$973.60
|
| Rate for Payer: Meridian Medicaid |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.96
|
| Rate for Payer: Priority Health Narrow Network |
$425.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$349.01
|
| Rate for Payer: UHC Exchange |
$349.01
|
| Rate for Payer: UHCCP Medicaid |
$152.30
|
|
|
PR COLONOSCOPY STOMA CONTROL BLEEDING
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 44391
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$3,239.54 |
| Rate for Payer: Aetna Commercial |
$306.27
|
| Rate for Payer: Aetna Medicare |
$802.00
|
| Rate for Payer: BCBS Complete |
$152.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,239.54
|
| Rate for Payer: BCN Commercial |
$941.68
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Meridian Medicaid |
$152.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,042.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$405.69
|
| Rate for Payer: Priority Health Narrow Network |
$405.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$316.18
|
| Rate for Payer: UHC Exchange |
$316.18
|
| Rate for Payer: UHCCP Medicaid |
$144.84
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$1,009.00
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
44388
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$4,017.19 |
| Rate for Payer: Aetna Commercial |
$208.34
|
| Rate for Payer: Aetna Medicare |
$504.50
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,017.19
|
| Rate for Payer: BCN Commercial |
$463.76
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Cash Price |
$807.20
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$655.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.63
|
| Rate for Payer: Priority Health Narrow Network |
$275.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.64
|
| Rate for Payer: UHC Exchange |
$207.64
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
