|
PR COLONOSCOPY W/STENT
|
Professional
|
Both
|
$1,602.00
|
|
|
Service Code
|
HCPCS G6025
|
| Min. Negotiated Rate |
$640.80 |
| Max. Negotiated Rate |
$1,041.30 |
| Rate for Payer: Aetna Medicare |
$801.00
|
| Rate for Payer: BCBS Complete |
$640.80
|
| Rate for Payer: Cash Price |
$1,281.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,041.30
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$1,384.58 |
| Rate for Payer: Aetna Commercial |
$1,066.50
|
| 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 |
$1,149.45
|
| Rate for Payer: ASR Commercial |
$1,149.45
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$970.40
|
| Rate for Payer: BCN Commercial |
$918.73
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| 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 |
$893.28
|
| Rate for Payer: Healthscope Commercial |
$1,185.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$893.28
|
| Rate for Payer: Mclaren Commercial |
$1,066.50
|
| 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 |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| 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 |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.30
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$830.68
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.80
|
| 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 COLORECTAL SCRN; HI RISK IND
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
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 COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$2,245.28 |
| Rate for Payer: Aetna Commercial |
$184.58
|
| Rate for Payer: Aetna Medicare |
$592.50
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.28
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| 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 |
$58.36
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$2,245.28 |
| Rate for Payer: Aetna Commercial |
$184.58
|
| Rate for Payer: Aetna Medicare |
$592.50
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,245.28
|
| Rate for Payer: BCN Commercial |
$497.96
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| 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 |
$58.36
|
|
|
PR COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 92283
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,441.20 |
| Rate for Payer: Aetna Commercial |
$56.23
|
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,441.20
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.38
|
| Rate for Payer: Priority Health Narrow Network |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.58
|
| Rate for Payer: UHC Exchange |
$47.58
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
PR COLOSTOMY/SKIN LEVEL CECOSTOMY
|
Professional
|
Both
|
$2,695.00
|
|
|
Service Code
|
HCPCS 44320
|
| Min. Negotiated Rate |
$262.57 |
| Max. Negotiated Rate |
$2,144.76 |
| Rate for Payer: Aetna Commercial |
$1,615.18
|
| Rate for Payer: Aetna Medicare |
$1,347.50
|
| Rate for Payer: BCBS Complete |
$808.05
|
| Rate for Payer: BCBS Trust/PPO |
$262.57
|
| Rate for Payer: BCN Commercial |
$1,745.56
|
| Rate for Payer: Cash Price |
$2,156.00
|
| Rate for Payer: Cash Price |
$2,156.00
|
| Rate for Payer: Meridian Medicaid |
$808.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$769.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,144.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,144.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,446.48
|
| Rate for Payer: UHC Exchange |
$1,446.48
|
| Rate for Payer: UHCCP Medicaid |
$769.57
|
|
|
PR COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX
|
Professional
|
Both
|
$2,766.00
|
|
|
Service Code
|
HCPCS 44322
|
| Min. Negotiated Rate |
$644.96 |
| Max. Negotiated Rate |
$1,802.91 |
| Rate for Payer: Aetna Commercial |
$1,358.01
|
| Rate for Payer: Aetna Medicare |
$1,383.00
|
| Rate for Payer: BCBS Complete |
$677.21
|
| Rate for Payer: BCBS Trust/PPO |
$955.17
|
| Rate for Payer: BCN Commercial |
$1,471.41
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Meridian Medicaid |
$677.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,802.91
|
| Rate for Payer: Priority Health Narrow Network |
$1,802.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,151.90
|
| Rate for Payer: UHC Exchange |
$1,151.90
|
| Rate for Payer: UHCCP Medicaid |
$644.96
|
|
|
PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,872.00
|
|
|
Service Code
|
HCPCS 44025
|
| Min. Negotiated Rate |
$631.55 |
| Max. Negotiated Rate |
$2,143.84 |
| Rate for Payer: Aetna Commercial |
$1,320.54
|
| Rate for Payer: Aetna Medicare |
$1,436.00
|
| Rate for Payer: BCBS Complete |
$663.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,143.84
|
| Rate for Payer: BCN Commercial |
$1,427.91
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Meridian Medicaid |
$663.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$631.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,756.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,756.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,191.36
|
| Rate for Payer: UHC Exchange |
$1,191.36
|
| Rate for Payer: UHCCP Medicaid |
$631.55
|
|
|
PR COLPOCENTESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 57020
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$2,675.31 |
| Rate for Payer: Aetna Commercial |
$96.32
|
| Rate for Payer: Aetna Medicare |
$86.00
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,675.31
|
| Rate for Payer: BCN Commercial |
$185.69
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.56
|
| Rate for Payer: Priority Health Narrow Network |
$117.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.96
|
| Rate for Payer: UHC Exchange |
$93.96
|
| Rate for Payer: UHCCP Medicaid |
$50.48
|
|
|
PR COLPOCLEISIS LE FORT TYPE
|
Professional
|
Both
|
$2,636.00
|
|
|
Service Code
|
HCPCS 57120
|
| Min. Negotiated Rate |
$341.01 |
| Max. Negotiated Rate |
$1,901.88 |
| Rate for Payer: Aetna Commercial |
$629.10
|
| Rate for Payer: Aetna Medicare |
$1,318.00
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.88
|
| Rate for Payer: BCN Commercial |
$779.93
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,713.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.15
|
| Rate for Payer: Priority Health Narrow Network |
$796.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.04
|
| Rate for Payer: UHC Exchange |
$583.04
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 57210
|
| Min. Negotiated Rate |
$252.62 |
| Max. Negotiated Rate |
$2,571.24 |
| Rate for Payer: Aetna Commercial |
$464.42
|
| Rate for Payer: Aetna Medicare |
$539.50
|
| Rate for Payer: BCBS Complete |
$265.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.24
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Meridian Medicaid |
$265.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$591.29
|
| Rate for Payer: Priority Health Narrow Network |
$591.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$416.08
|
| Rate for Payer: UHC Exchange |
$416.08
|
| Rate for Payer: UHCCP Medicaid |
$252.62
|
|
|
PR COLPOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,103.00
|
|
|
Service Code
|
HCPCS 57280
|
| Min. Negotiated Rate |
$618.55 |
| Max. Negotiated Rate |
$2,847.01 |
| Rate for Payer: Aetna Commercial |
$1,153.81
|
| Rate for Payer: Aetna Medicare |
$1,051.50
|
| Rate for Payer: BCBS Complete |
$649.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,847.01
|
| Rate for Payer: BCN Commercial |
$1,412.28
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Meridian Medicaid |
$649.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$618.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,440.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,440.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,103.87
|
| Rate for Payer: UHC Exchange |
$1,103.87
|
| Rate for Payer: UHCCP Medicaid |
$618.55
|
|
|
PR COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$2,128.00
|
|
|
Service Code
|
HCPCS 57282
|
| Min. Negotiated Rate |
$444.96 |
| Max. Negotiated Rate |
$2,780.44 |
| Rate for Payer: Aetna Commercial |
$827.22
|
| Rate for Payer: Aetna Medicare |
$1,064.00
|
| Rate for Payer: BCBS Complete |
$467.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,780.44
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: Cash Price |
$1,702.40
|
| Rate for Payer: Cash Price |
$1,702.40
|
| Rate for Payer: Meridian Medicaid |
$467.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.72
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$573.52
|
| Rate for Payer: UHC Exchange |
$573.52
|
| Rate for Payer: UHCCP Medicaid |
$444.96
|
|
|
PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$1,164.00
|
|
|
Service Code
|
HCPCS 57283
|
| Min. Negotiated Rate |
$448.58 |
| Max. Negotiated Rate |
$3,053.05 |
| Rate for Payer: Aetna Commercial |
$832.81
|
| Rate for Payer: Aetna Medicare |
$582.00
|
| Rate for Payer: BCBS Complete |
$471.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,053.05
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: Cash Price |
$931.20
|
| Rate for Payer: Cash Price |
$931.20
|
| Rate for Payer: Meridian Medicaid |
$471.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,045.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,045.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$791.69
|
| Rate for Payer: UHC Exchange |
$791.69
|
| Rate for Payer: UHCCP Medicaid |
$448.58
|
|
|
PR COLPORRHAPHY SUTURE INJURY VAGINA
|
Professional
|
Both
|
$875.00
|
|
|
Service Code
|
HCPCS 57200
|
| Min. Negotiated Rate |
$213.85 |
| Max. Negotiated Rate |
$2,224.14 |
| Rate for Payer: Aetna Commercial |
$387.33
|
| Rate for Payer: Aetna Medicare |
$437.50
|
| Rate for Payer: BCBS Complete |
$224.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.14
|
| Rate for Payer: BCN Commercial |
$487.70
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Meridian Medicaid |
$224.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$500.51
|
| Rate for Payer: Priority Health Narrow Network |
$500.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$336.54
|
| Rate for Payer: UHC Exchange |
$336.54
|
| Rate for Payer: UHCCP Medicaid |
$213.85
|
|
|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$246.72 |
| Rate for Payer: Aetna Commercial |
$159.65
|
| Rate for Payer: Aetna Medicare |
$180.50
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS Trust/PPO |
$246.72
|
| Rate for Payer: BCN Commercial |
$199.48
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.91
|
| Rate for Payer: Priority Health Narrow Network |
$198.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$155.71
|
| Rate for Payer: UHC Exchange |
$155.71
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 57456
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$1,290.64 |
| Rate for Payer: Aetna Commercial |
$120.98
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.64
|
| Rate for Payer: BCN Commercial |
$179.84
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Meridian Medicaid |
$67.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.30
|
| Rate for Payer: Priority Health Narrow Network |
$150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.20
|
| Rate for Payer: UHC Exchange |
$119.20
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
|
|
PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 57452
|
| Min. Negotiated Rate |
$58.36 |
| Max. Negotiated Rate |
$304.30 |
| Rate for Payer: Aetna Commercial |
$107.71
|
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: BCBS Complete |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$304.30
|
| Rate for Payer: BCN Commercial |
$150.00
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Meridian Medicaid |
$61.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.41
|
| Rate for Payer: Priority Health Narrow Network |
$135.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.10
|
| Rate for Payer: UHC Exchange |
$104.10
|
| Rate for Payer: UHCCP Medicaid |
$58.36
|
|
|
PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 57455
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$1,460.22 |
| Rate for Payer: Aetna Commercial |
$130.36
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,460.22
|
| Rate for Payer: BCN Commercial |
$190.44
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$236.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.21
|
| Rate for Payer: Priority Health Narrow Network |
$161.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.22
|
| Rate for Payer: UHC Exchange |
$127.22
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$1,582.26 |
| Rate for Payer: Aetna Commercial |
$221.07
|
| Rate for Payer: Aetna Medicare |
$480.00
|
| Rate for Payer: BCBS Complete |
$123.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.26
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Meridian Medicaid |
$123.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.33
|
| Rate for Payer: Priority Health Narrow Network |
$271.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.41
|
| Rate for Payer: UHC Exchange |
$217.41
|
| Rate for Payer: UHCCP Medicaid |
$117.15
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Professional
|
Both
|
$960.00
|
|
|
Service Code
|
HCPCS 57461
|
| Min. Negotiated Rate |
$117.15 |
| Max. Negotiated Rate |
$1,582.26 |
| Rate for Payer: Aetna Commercial |
$221.07
|
| Rate for Payer: Aetna Medicare |
$480.00
|
| Rate for Payer: BCBS Complete |
$123.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.26
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Meridian Medicaid |
$123.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.33
|
| Rate for Payer: Priority Health Narrow Network |
$271.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$217.41
|
| Rate for Payer: UHC Exchange |
$217.41
|
| Rate for Payer: UHCCP Medicaid |
$117.15
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$960.00
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$331.06 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$931.20
|
| Rate for Payer: ASR Commercial |
$931.20
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$786.14
|
| Rate for Payer: BCCCP Commercial |
$331.06
|
| Rate for Payer: BCN Commercial |
$744.29
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$902.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$960.00
|
| Rate for Payer: Healthscope Whirlpool |
$931.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$864.00
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.00
|
| Rate for Payer: Nomi Health Commercial |
$787.20
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$841.15
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$672.96
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$960.00
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
57461
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$960.00 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: ASR ASR |
$931.20
|
| Rate for Payer: ASR Commercial |
$931.20
|
| Rate for Payer: BCBS Trust/PPO |
$782.30
|
| Rate for Payer: BCN Commercial |
$744.29
|
| Rate for Payer: Cash Price |
$768.00
|
| Rate for Payer: Cofinity Commercial |
$902.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$768.00
|
| Rate for Payer: Healthscope Commercial |
$960.00
|
| Rate for Payer: Healthscope Whirlpool |
$931.20
|
| Rate for Payer: Mclaren Commercial |
$864.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$816.00
|
| Rate for Payer: Nomi Health Commercial |
$787.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$624.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$844.80
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
IP
|
$647.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$420.55 |
| Max. Negotiated Rate |
$647.00 |
| Rate for Payer: Aetna Commercial |
$582.30
|
| Rate for Payer: ASR ASR |
$627.59
|
| Rate for Payer: ASR Commercial |
$627.59
|
| Rate for Payer: BCBS Trust/PPO |
$527.24
|
| Rate for Payer: BCN Commercial |
$501.62
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cofinity Commercial |
$608.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.60
|
| Rate for Payer: Healthscope Commercial |
$647.00
|
| Rate for Payer: Healthscope Whirlpool |
$627.59
|
| Rate for Payer: Mclaren Commercial |
$582.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.95
|
| Rate for Payer: Nomi Health Commercial |
$530.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.36
|
|
