|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Professional
|
Both
|
$1,371.00
|
|
|
Service Code
|
HCPCS 44393
|
| Min. Negotiated Rate |
$548.40 |
| Max. Negotiated Rate |
$891.15 |
| Rate for Payer: Aetna Medicare |
$685.50
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Facility
|
IP
|
$1,371.00
|
|
|
Service Code
|
CPT 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$891.15 |
| Max. Negotiated Rate |
$1,371.00 |
| Rate for Payer: Aetna Commercial |
$1,233.90
|
| Rate for Payer: ASR ASR |
$1,329.87
|
| Rate for Payer: ASR Commercial |
$1,329.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.23
|
| Rate for Payer: BCN Commercial |
$1,062.94
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,288.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Healthscope Commercial |
$1,371.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,329.87
|
| Rate for Payer: Mclaren Commercial |
$1,233.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: Nomi Health Commercial |
$1,124.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,206.48
|
|
|
PR COLONOSCOPY THRU STOMA,LESION REMOVAL
|
Facility
|
OP
|
$1,371.00
|
|
|
Service Code
|
CPT 44393
|
| Hospital Charge Code |
44393
|
| Min. Negotiated Rate |
$548.40 |
| Max. Negotiated Rate |
$1,371.00 |
| Rate for Payer: Aetna Commercial |
$1,233.90
|
| Rate for Payer: Aetna Medicare |
$685.50
|
| Rate for Payer: ASR ASR |
$1,329.87
|
| Rate for Payer: ASR Commercial |
$1,329.87
|
| Rate for Payer: BCBS Complete |
$548.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,122.71
|
| Rate for Payer: BCN Commercial |
$1,062.94
|
| Rate for Payer: Cash Price |
$1,096.80
|
| Rate for Payer: Cofinity Commercial |
$1,288.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,096.80
|
| Rate for Payer: Healthscope Commercial |
$1,371.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,329.87
|
| Rate for Payer: Mclaren Commercial |
$1,233.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,165.35
|
| Rate for Payer: Nomi Health Commercial |
$1,124.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,201.27
|
| Rate for Payer: Priority Health Narrow Network |
$961.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,206.48
|
|
|
PR COLONOSCOPY,TRANSENDOSCOPIC STENT
|
Professional
|
Both
|
$1,602.00
|
|
|
Service Code
|
HCPCS 45387
|
| 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 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45380
|
| Min. Negotiated Rate |
$189.86 |
| Max. Negotiated Rate |
$731.25 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$189.86
|
| Rate for Payer: BCBS Complete |
$450.00
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Cofinity Commercial |
$254.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.86
|
| Rate for Payer: Healthscope Commercial |
$227.83
|
| Rate for Payer: Healthscope Whirlpool |
$227.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.35
|
| Rate for Payer: Nomi Health Commercial |
$227.83
|
| Rate for Payer: PACE SWMI |
$189.86
|
| Rate for Payer: PHP Medicare Advantage |
$189.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP DNSP |
$189.86
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
45380
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$731.25 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$1,012.50
|
| Rate for Payer: ASR ASR |
$1,091.25
|
| Rate for Payer: ASR Commercial |
$1,091.25
|
| Rate for Payer: BCBS Trust/PPO |
$916.76
|
| Rate for Payer: BCN Commercial |
$872.21
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$1,057.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,125.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,091.25
|
| Rate for Payer: Mclaren Commercial |
$1,012.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Nomi Health Commercial |
$922.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$990.00
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,125.00
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
45380
|
| Min. Negotiated Rate |
$189.86 |
| Max. Negotiated Rate |
$731.25 |
| Rate for Payer: Aetna Commercial |
$254.41
|
| Rate for Payer: Aetna Medicare |
$189.86
|
| Rate for Payer: BCBS Complete |
$450.00
|
| Rate for Payer: BCBS MAPPO |
$189.86
|
| Rate for Payer: BCN Medicare Advantage |
$189.86
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Cofinity Commercial |
$254.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.86
|
| Rate for Payer: Healthscope Commercial |
$227.83
|
| Rate for Payer: Healthscope Whirlpool |
$227.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.35
|
| Rate for Payer: Nomi Health Commercial |
$227.83
|
| Rate for Payer: PACE SWMI |
$189.86
|
| Rate for Payer: PHP Medicare Advantage |
$189.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health Medicare |
$189.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.86
|
| Rate for Payer: UHC Medicare Advantage |
$189.86
|
| Rate for Payer: UHCCP DNSP |
$189.86
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
45380
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$616.36 |
| Max. Negotiated Rate |
$1,782.39 |
| Rate for Payer: Aetna Commercial |
$1,012.50
|
| Rate for Payer: Aetna Medicare |
$1,149.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: ASR ASR |
$1,091.25
|
| Rate for Payer: ASR Commercial |
$1,091.25
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCBS Trust/PPO |
$921.26
|
| Rate for Payer: BCN Commercial |
$872.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$1,057.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$1,125.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,091.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,149.93
|
| Rate for Payer: Mclaren Commercial |
$1,012.50
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Nomi Health Commercial |
$922.50
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$1,264.92
|
| Rate for Payer: PHP Medicaid |
$616.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$985.73
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health Narrow Network |
$788.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$990.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$1,782.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP DNSP |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: VA VA |
$1,149.93
|
|
|
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
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$174.51 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$174.51
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCN Medicare Advantage |
$174.51
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$251.29
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.51
|
| Rate for Payer: Healthscope Commercial |
$209.41
|
| Rate for Payer: Healthscope Whirlpool |
$209.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.24
|
| Rate for Payer: Nomi Health Commercial |
$209.41
|
| Rate for Payer: PACE SWMI |
$174.51
|
| Rate for Payer: PHP Medicare Advantage |
$174.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
| Rate for Payer: UHCCP DNSP |
$174.51
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
| Min. Negotiated Rate |
$174.51 |
| Max. Negotiated Rate |
$770.25 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$174.51
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$174.51
|
| Rate for Payer: BCN Medicare Advantage |
$174.51
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$251.29
|
| Rate for Payer: Cofinity Commercial |
$233.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.51
|
| Rate for Payer: Healthscope Commercial |
$209.41
|
| Rate for Payer: Healthscope Whirlpool |
$209.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.24
|
| Rate for Payer: Nomi Health Commercial |
$209.41
|
| Rate for Payer: PACE SWMI |
$174.51
|
| Rate for Payer: PHP Medicare Advantage |
$174.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$174.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.51
|
| Rate for Payer: UHC Medicare Advantage |
$174.51
|
| Rate for Payer: UHCCP DNSP |
$174.51
|
|
|
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
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
HCPCS G0105
|
| Hospital Charge Code |
G0105
|
|
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 COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 92283
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$70.11 |
| Rate for Payer: Aetna Commercial |
$65.24
|
| Rate for Payer: Aetna Medicare |
$48.69
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS MAPPO |
$48.69
|
| Rate for Payer: BCN Medicare Advantage |
$48.69
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$70.11
|
| Rate for Payer: Cofinity Commercial |
$65.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.69
|
| Rate for Payer: Healthscope Commercial |
$58.43
|
| Rate for Payer: Healthscope Whirlpool |
$58.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.12
|
| Rate for Payer: Nomi Health Commercial |
$58.43
|
| Rate for Payer: PACE SWMI |
$48.69
|
| Rate for Payer: PHP Medicare Advantage |
$48.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health Medicare |
$48.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.69
|
| Rate for Payer: UHC Medicare Advantage |
$48.69
|
| Rate for Payer: UHCCP DNSP |
$48.69
|
|
|
PR COLOSTOMY/SKIN LEVEL CECOSTOMY
|
Professional
|
Both
|
$2,695.00
|
|
|
Service Code
|
HCPCS 44320
|
| Min. Negotiated Rate |
$1,078.00 |
| Max. Negotiated Rate |
$1,751.75 |
| Rate for Payer: Aetna Commercial |
$1,553.42
|
| Rate for Payer: Aetna Medicare |
$1,159.27
|
| Rate for Payer: BCBS Complete |
$1,078.00
|
| Rate for Payer: BCBS MAPPO |
$1,159.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,159.27
|
| Rate for Payer: Cash Price |
$2,156.00
|
| Rate for Payer: Cash Price |
$2,156.00
|
| Rate for Payer: Cofinity Commercial |
$1,669.35
|
| Rate for Payer: Cofinity Commercial |
$1,553.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,159.27
|
| Rate for Payer: Healthscope Commercial |
$1,391.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,391.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,217.23
|
| Rate for Payer: Nomi Health Commercial |
$1,391.12
|
| Rate for Payer: PACE SWMI |
$1,159.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.75
|
| Rate for Payer: Priority Health Medicare |
$1,159.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,159.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,159.27
|
| Rate for Payer: UHCCP DNSP |
$1,159.27
|
|
|
PR COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX
|
Professional
|
Both
|
$2,766.00
|
|
|
Service Code
|
HCPCS 44322
|
| Min. Negotiated Rate |
$959.53 |
| Max. Negotiated Rate |
$1,797.90 |
| Rate for Payer: Aetna Commercial |
$1,285.77
|
| Rate for Payer: Aetna Medicare |
$959.53
|
| Rate for Payer: BCBS Complete |
$1,106.40
|
| Rate for Payer: BCBS MAPPO |
$959.53
|
| Rate for Payer: BCN Medicare Advantage |
$959.53
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cofinity Commercial |
$1,381.72
|
| Rate for Payer: Cofinity Commercial |
$1,285.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$959.53
|
| Rate for Payer: Healthscope Commercial |
$1,151.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,151.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,007.51
|
| Rate for Payer: Nomi Health Commercial |
$1,151.44
|
| Rate for Payer: PACE SWMI |
$959.53
|
| Rate for Payer: PHP Medicare Advantage |
$959.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,797.90
|
| Rate for Payer: Priority Health Medicare |
$959.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$959.53
|
| Rate for Payer: UHC Medicare Advantage |
$959.53
|
| Rate for Payer: UHCCP DNSP |
$959.53
|
|
|
PR COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,872.00
|
|
|
Service Code
|
HCPCS 44025
|
| Min. Negotiated Rate |
$953.96 |
| Max. Negotiated Rate |
$1,866.80 |
| Rate for Payer: Aetna Commercial |
$1,278.31
|
| Rate for Payer: Aetna Medicare |
$953.96
|
| Rate for Payer: BCBS Complete |
$1,148.80
|
| Rate for Payer: BCBS MAPPO |
$953.96
|
| Rate for Payer: BCN Medicare Advantage |
$953.96
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cash Price |
$2,297.60
|
| Rate for Payer: Cofinity Commercial |
$1,373.70
|
| Rate for Payer: Cofinity Commercial |
$1,278.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.96
|
| Rate for Payer: Healthscope Commercial |
$1,144.75
|
| Rate for Payer: Healthscope Whirlpool |
$1,144.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.66
|
| Rate for Payer: Nomi Health Commercial |
$1,144.75
|
| Rate for Payer: PACE SWMI |
$953.96
|
| Rate for Payer: PHP Medicare Advantage |
$953.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,866.80
|
| Rate for Payer: Priority Health Medicare |
$953.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.96
|
| Rate for Payer: UHC Medicare Advantage |
$953.96
|
| Rate for Payer: UHCCP DNSP |
$953.96
|
|
|
PR COLPOCENTESIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 57020
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Commercial |
$102.22
|
| Rate for Payer: Aetna Medicare |
$76.28
|
| Rate for Payer: BCBS Complete |
$68.80
|
| Rate for Payer: BCBS MAPPO |
$76.28
|
| Rate for Payer: BCN Medicare Advantage |
$76.28
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$109.84
|
| Rate for Payer: Cofinity Commercial |
$102.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.28
|
| Rate for Payer: Healthscope Commercial |
$91.54
|
| Rate for Payer: Healthscope Whirlpool |
$91.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.09
|
| Rate for Payer: Nomi Health Commercial |
$91.54
|
| Rate for Payer: PACE SWMI |
$76.28
|
| Rate for Payer: PHP Medicare Advantage |
$76.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.80
|
| Rate for Payer: Priority Health Medicare |
$76.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.28
|
| Rate for Payer: UHC Medicare Advantage |
$76.28
|
| Rate for Payer: UHCCP DNSP |
$76.28
|
|
|
PR COLPOCLEISIS LE FORT TYPE
|
Professional
|
Both
|
$2,636.00
|
|
|
Service Code
|
HCPCS 57120
|
| Min. Negotiated Rate |
$506.72 |
| Max. Negotiated Rate |
$1,713.40 |
| Rate for Payer: Aetna Commercial |
$679.00
|
| Rate for Payer: Aetna Medicare |
$506.72
|
| Rate for Payer: BCBS Complete |
$1,054.40
|
| Rate for Payer: BCBS MAPPO |
$506.72
|
| Rate for Payer: BCN Medicare Advantage |
$506.72
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cash Price |
$2,108.80
|
| Rate for Payer: Cofinity Commercial |
$729.68
|
| Rate for Payer: Cofinity Commercial |
$679.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.72
|
| Rate for Payer: Healthscope Commercial |
$608.06
|
| Rate for Payer: Healthscope Whirlpool |
$608.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.06
|
| Rate for Payer: Nomi Health Commercial |
$608.06
|
| Rate for Payer: PACE SWMI |
$506.72
|
| Rate for Payer: PHP Medicare Advantage |
$506.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,713.40
|
| Rate for Payer: Priority Health Medicare |
$506.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.72
|
| Rate for Payer: UHC Medicare Advantage |
$506.72
|
| Rate for Payer: UHCCP DNSP |
$506.72
|
|
|
PR COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU
|
Professional
|
Both
|
$1,079.00
|
|
|
Service Code
|
HCPCS 57210
|
| Min. Negotiated Rate |
$373.72 |
| Max. Negotiated Rate |
$701.35 |
| Rate for Payer: Aetna Commercial |
$500.78
|
| Rate for Payer: Aetna Medicare |
$373.72
|
| Rate for Payer: BCBS Complete |
$431.60
|
| Rate for Payer: BCBS MAPPO |
$373.72
|
| Rate for Payer: BCN Medicare Advantage |
$373.72
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cash Price |
$863.20
|
| Rate for Payer: Cofinity Commercial |
$538.16
|
| Rate for Payer: Cofinity Commercial |
$500.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.72
|
| Rate for Payer: Healthscope Commercial |
$448.46
|
| Rate for Payer: Healthscope Whirlpool |
$448.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$392.41
|
| Rate for Payer: Nomi Health Commercial |
$448.46
|
| Rate for Payer: PACE SWMI |
$373.72
|
| Rate for Payer: PHP Medicare Advantage |
$373.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.35
|
| Rate for Payer: Priority Health Medicare |
$373.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.72
|
| Rate for Payer: UHC Medicare Advantage |
$373.72
|
| Rate for Payer: UHCCP DNSP |
$373.72
|
|
|
PR COLPOPEXY ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,103.00
|
|
|
Service Code
|
HCPCS 57280
|
| Min. Negotiated Rate |
$841.20 |
| Max. Negotiated Rate |
$1,366.95 |
| Rate for Payer: Aetna Commercial |
$1,240.60
|
| Rate for Payer: Aetna Medicare |
$925.82
|
| Rate for Payer: BCBS Complete |
$841.20
|
| Rate for Payer: BCBS MAPPO |
$925.82
|
| Rate for Payer: BCN Medicare Advantage |
$925.82
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cash Price |
$1,682.40
|
| Rate for Payer: Cofinity Commercial |
$1,333.18
|
| Rate for Payer: Cofinity Commercial |
$1,240.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.82
|
| Rate for Payer: Healthscope Commercial |
$1,110.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,110.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.11
|
| Rate for Payer: Nomi Health Commercial |
$1,110.98
|
| Rate for Payer: PACE SWMI |
$925.82
|
| Rate for Payer: PHP Medicare Advantage |
$925.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.95
|
| Rate for Payer: Priority Health Medicare |
$925.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.82
|
| Rate for Payer: UHC Medicare Advantage |
$925.82
|
| Rate for Payer: UHCCP DNSP |
$925.82
|
|
|
PR COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$2,128.00
|
|
|
Service Code
|
HCPCS 57282
|
| Min. Negotiated Rate |
$664.31 |
| Max. Negotiated Rate |
$1,383.20 |
| Rate for Payer: Aetna Commercial |
$890.18
|
| Rate for Payer: Aetna Medicare |
$664.31
|
| Rate for Payer: BCBS Complete |
$851.20
|
| Rate for Payer: BCBS MAPPO |
$664.31
|
| Rate for Payer: BCN Medicare Advantage |
$664.31
|
| Rate for Payer: Cash Price |
$1,702.40
|
| Rate for Payer: Cash Price |
$1,702.40
|
| Rate for Payer: Cofinity Commercial |
$956.61
|
| Rate for Payer: Cofinity Commercial |
$890.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$664.31
|
| Rate for Payer: Healthscope Commercial |
$797.17
|
| Rate for Payer: Healthscope Whirlpool |
$797.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$697.53
|
| Rate for Payer: Nomi Health Commercial |
$797.17
|
| Rate for Payer: PACE SWMI |
$664.31
|
| Rate for Payer: PHP Medicare Advantage |
$664.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,383.20
|
| Rate for Payer: Priority Health Medicare |
$664.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$664.31
|
| Rate for Payer: UHC Medicare Advantage |
$664.31
|
| Rate for Payer: UHCCP DNSP |
$664.31
|
|
|
PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH
|
Professional
|
Both
|
$1,164.00
|
|
|
Service Code
|
HCPCS 57283
|
| Min. Negotiated Rate |
$465.60 |
| Max. Negotiated Rate |
$965.17 |
| Rate for Payer: Aetna Commercial |
$898.15
|
| Rate for Payer: Aetna Medicare |
$670.26
|
| Rate for Payer: BCBS Complete |
$465.60
|
| Rate for Payer: BCBS MAPPO |
$670.26
|
| Rate for Payer: BCN Medicare Advantage |
$670.26
|
| Rate for Payer: Cash Price |
$931.20
|
| Rate for Payer: Cash Price |
$931.20
|
| Rate for Payer: Cofinity Commercial |
$965.17
|
| Rate for Payer: Cofinity Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.26
|
| Rate for Payer: Healthscope Commercial |
$804.31
|
| Rate for Payer: Healthscope Whirlpool |
$804.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.77
|
| Rate for Payer: Nomi Health Commercial |
$804.31
|
| Rate for Payer: PACE SWMI |
$670.26
|
| Rate for Payer: PHP Medicare Advantage |
$670.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$756.60
|
| Rate for Payer: Priority Health Medicare |
$670.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.26
|
| Rate for Payer: UHC Medicare Advantage |
$670.26
|
| Rate for Payer: UHCCP DNSP |
$670.26
|
|
|
PR COLPORRHAPHY SUTURE INJURY VAGINA
|
Professional
|
Both
|
$875.00
|
|
|
Service Code
|
HCPCS 57200
|
| Min. Negotiated Rate |
$314.77 |
| Max. Negotiated Rate |
$568.75 |
| Rate for Payer: Aetna Commercial |
$421.79
|
| Rate for Payer: Aetna Medicare |
$314.77
|
| Rate for Payer: BCBS Complete |
$350.00
|
| Rate for Payer: BCBS MAPPO |
$314.77
|
| Rate for Payer: BCN Medicare Advantage |
$314.77
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cash Price |
$700.00
|
| Rate for Payer: Cofinity Commercial |
$453.27
|
| Rate for Payer: Cofinity Commercial |
$421.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.77
|
| Rate for Payer: Healthscope Commercial |
$377.72
|
| Rate for Payer: Healthscope Whirlpool |
$377.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.51
|
| Rate for Payer: Nomi Health Commercial |
$377.72
|
| Rate for Payer: PACE SWMI |
$314.77
|
| Rate for Payer: PHP Medicare Advantage |
$314.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.75
|
| Rate for Payer: Priority Health Medicare |
$314.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.77
|
| Rate for Payer: UHC Medicare Advantage |
$314.77
|
| Rate for Payer: UHCCP DNSP |
$314.77
|
|
|
PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 57454
|
| Min. Negotiated Rate |
$128.47 |
| Max. Negotiated Rate |
$234.65 |
| Rate for Payer: Aetna Commercial |
$172.15
|
| Rate for Payer: Aetna Medicare |
$128.47
|
| Rate for Payer: BCBS Complete |
$144.40
|
| Rate for Payer: BCBS MAPPO |
$128.47
|
| Rate for Payer: BCN Medicare Advantage |
$128.47
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$185.00
|
| Rate for Payer: Cofinity Commercial |
$172.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.47
|
| Rate for Payer: Healthscope Commercial |
$154.16
|
| Rate for Payer: Healthscope Whirlpool |
$154.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.89
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: PACE SWMI |
$128.47
|
| Rate for Payer: PHP Medicare Advantage |
$128.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health Medicare |
$128.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.47
|
| Rate for Payer: UHC Medicare Advantage |
$128.47
|
| Rate for Payer: UHCCP DNSP |
$128.47
|
|
