|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 57460
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$1,524.15 |
| Rate for Payer: Aetna Commercial |
$191.11
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.15
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.10
|
| Rate for Payer: Priority Health Narrow Network |
$237.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.47
|
| Rate for Payer: UHC Exchange |
$187.47
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Professional
|
Both
|
$647.00
|
|
|
Service Code
|
HCPCS 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$1,524.15 |
| Rate for Payer: Aetna Commercial |
$191.11
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,524.15
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Cash Price |
$517.60
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.10
|
| Rate for Payer: Priority Health Narrow Network |
$237.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.47
|
| Rate for Payer: UHC Exchange |
$187.47
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX
|
Facility
|
OP
|
$647.00
|
|
|
Service Code
|
CPT 57460
|
| Hospital Charge Code |
57460
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$582.30
|
| 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 |
$627.59
|
| Rate for Payer: ASR Commercial |
$627.59
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$529.83
|
| Rate for Payer: BCCCP Commercial |
$295.08
|
| Rate for Payer: BCN Commercial |
$501.62
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$517.60
|
| 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: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$647.00
|
| Rate for Payer: Healthscope Whirlpool |
$627.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$582.30
|
| 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 |
$549.95
|
| Rate for Payer: Nomi Health Commercial |
$530.54
|
| 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 |
$420.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$566.90
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$453.55
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.36
|
| 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 ENTIRE VAGINA W/CERVIX IF PRESENT
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 57420
|
| Min. Negotiated Rate |
$57.72 |
| Max. Negotiated Rate |
$1,752.90 |
| Rate for Payer: Aetna Commercial |
$107.00
|
| Rate for Payer: Aetna Medicare |
$117.50
|
| Rate for Payer: BCBS Complete |
$60.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,752.90
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Meridian Medicaid |
$60.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.43
|
| Rate for Payer: Priority Health Narrow Network |
$133.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.09
|
| Rate for Payer: UHC Exchange |
$103.09
|
| Rate for Payer: UHCCP Medicaid |
$57.72
|
|
|
PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX
|
Professional
|
Both
|
$305.00
|
|
|
Service Code
|
HCPCS 57421
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$260.95 |
| Rate for Payer: Aetna Commercial |
$144.96
|
| Rate for Payer: Aetna Medicare |
$152.50
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS Trust/PPO |
$122.57
|
| Rate for Payer: BCN Commercial |
$260.95
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.06
|
| Rate for Payer: Priority Health Narrow Network |
$181.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.77
|
| Rate for Payer: UHC Exchange |
$140.77
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR COLPOSCOPY VULVA
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 56820
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$1,801.50 |
| Rate for Payer: Aetna Commercial |
$100.46
|
| Rate for Payer: Aetna Medicare |
$161.00
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.50
|
| Rate for Payer: BCN Commercial |
$184.23
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.00
|
| Rate for Payer: Priority Health Narrow Network |
$125.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.62
|
| Rate for Payer: UHC Exchange |
$97.62
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$351.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$228.15 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Aetna Commercial |
$315.90
|
| Rate for Payer: ASR ASR |
$340.47
|
| Rate for Payer: ASR Commercial |
$340.47
|
| Rate for Payer: BCBS Trust/PPO |
$286.03
|
| Rate for Payer: BCN Commercial |
$272.13
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$329.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.80
|
| Rate for Payer: Healthscope Commercial |
$351.00
|
| Rate for Payer: Healthscope Whirlpool |
$340.47
|
| Rate for Payer: Mclaren Commercial |
$315.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.35
|
| Rate for Payer: Nomi Health Commercial |
$287.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.88
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 56821
|
| Hospital Charge Code |
56821
|
| Min. Negotiated Rate |
$72.63 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$135.19
|
| Rate for Payer: Aetna Medicare |
$175.50
|
| Rate for Payer: BCBS Complete |
$76.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Meridian Medicaid |
$76.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.66
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.45
|
| Rate for Payer: UHC Exchange |
$131.45
|
| Rate for Payer: UHCCP Medicaid |
$72.63
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Professional
|
Both
|
$351.00
|
|
|
Service Code
|
HCPCS 56821
|
| Min. Negotiated Rate |
$72.63 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$135.19
|
| Rate for Payer: Aetna Medicare |
$175.50
|
| Rate for Payer: BCBS Complete |
$76.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Meridian Medicaid |
$76.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.66
|
| Rate for Payer: Priority Health Narrow Network |
$168.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.45
|
| Rate for Payer: UHC Exchange |
$131.45
|
| Rate for Payer: UHCCP Medicaid |
$72.63
|
|
|
PR COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$351.00
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
56821
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$159.75 |
| Max. Negotiated Rate |
$461.96 |
| Rate for Payer: Aetna Commercial |
$315.90
|
| Rate for Payer: Aetna Medicare |
$298.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: ASR ASR |
$340.47
|
| Rate for Payer: ASR Commercial |
$340.47
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$287.43
|
| Rate for Payer: BCN Commercial |
$272.13
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cofinity Commercial |
$329.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$351.00
|
| Rate for Payer: Healthscope Whirlpool |
$340.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$298.04
|
| Rate for Payer: Mclaren Commercial |
$315.90
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.35
|
| Rate for Payer: Nomi Health Commercial |
$287.82
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$327.84
|
| Rate for Payer: PHP Medicaid |
$159.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.55
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$246.05
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$461.96
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP DNSP |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: VA VA |
$298.04
|
|
|
PR COLPOTOMY W/DRAINAGE PELVIC ABSCESS
|
Professional
|
Both
|
$1,003.00
|
|
|
Service Code
|
HCPCS 57010
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$1,747.09 |
| Rate for Payer: Aetna Commercial |
$541.29
|
| Rate for Payer: Aetna Medicare |
$501.50
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,747.09
|
| Rate for Payer: BCN Commercial |
$673.89
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Cash Price |
$802.40
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$651.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.02
|
| Rate for Payer: Priority Health Narrow Network |
$688.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$492.25
|
| Rate for Payer: UHC Exchange |
$492.25
|
| Rate for Payer: UHCCP Medicaid |
$294.15
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
OP
|
$1,424.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$619.21 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$1,281.60
|
| 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 |
$1,381.28
|
| Rate for Payer: ASR Commercial |
$1,381.28
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,166.11
|
| Rate for Payer: BCN Commercial |
$1,104.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,338.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,424.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,381.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$1,281.60
|
| 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 |
$1,210.40
|
| Rate for Payer: Nomi Health Commercial |
$1,167.68
|
| 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 |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,247.71
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$998.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,253.12
|
| 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 COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 45382
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$979.31 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: Aetna Medicare |
$712.00
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.60
|
| Rate for Payer: Priority Health Narrow Network |
$454.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$417.34
|
| Rate for Payer: UHC Exchange |
$417.34
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Facility
|
IP
|
$1,424.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$925.60 |
| Max. Negotiated Rate |
$1,424.00 |
| Rate for Payer: Aetna Commercial |
$1,281.60
|
| Rate for Payer: ASR ASR |
$1,381.28
|
| Rate for Payer: ASR Commercial |
$1,381.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.42
|
| Rate for Payer: BCN Commercial |
$1,104.03
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cofinity Commercial |
$1,338.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,139.20
|
| Rate for Payer: Healthscope Commercial |
$1,424.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,381.28
|
| Rate for Payer: Mclaren Commercial |
$1,281.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,210.40
|
| Rate for Payer: Nomi Health Commercial |
$1,167.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,253.12
|
|
|
PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,424.00
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
45382
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$979.31 |
| Rate for Payer: Aetna Commercial |
$344.31
|
| Rate for Payer: Aetna Medicare |
$712.00
|
| Rate for Payer: BCBS Complete |
$171.10
|
| Rate for Payer: BCBS Trust/PPO |
$315.92
|
| Rate for Payer: BCN Commercial |
$979.31
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Cash Price |
$1,139.20
|
| Rate for Payer: Meridian Medicaid |
$171.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.60
|
| Rate for Payer: Priority Health Narrow Network |
$454.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$417.34
|
| Rate for Payer: UHC Exchange |
$417.34
|
| Rate for Payer: UHCCP Medicaid |
$162.95
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Facility
|
OP
|
$1,320.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$619.21 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| 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 |
$1,280.40
|
| Rate for Payer: ASR Commercial |
$1,280.40
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.95
|
| Rate for Payer: BCN Commercial |
$1,023.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,240.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,320.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,280.40
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$1,188.00
|
| 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 |
$1,122.00
|
| Rate for Payer: Nomi Health Commercial |
$1,082.40
|
| 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 |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,156.58
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$925.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,161.60
|
| 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 COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$898.67 |
| Rate for Payer: Aetna Commercial |
$281.59
|
| Rate for Payer: Aetna Medicare |
$660.00
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.88
|
| Rate for Payer: Priority Health Narrow Network |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.20
|
| Rate for Payer: UHC Exchange |
$334.20
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Professional
|
Both
|
$1,320.00
|
|
|
Service Code
|
HCPCS 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$898.67 |
| Rate for Payer: Aetna Commercial |
$281.59
|
| Rate for Payer: Aetna Medicare |
$660.00
|
| Rate for Payer: BCBS Complete |
$140.68
|
| Rate for Payer: BCBS Trust/PPO |
$118.34
|
| Rate for Payer: BCN Commercial |
$898.67
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Meridian Medicaid |
$140.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.88
|
| Rate for Payer: Priority Health Narrow Network |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.20
|
| Rate for Payer: UHC Exchange |
$334.20
|
| Rate for Payer: UHCCP Medicaid |
$133.98
|
|
|
PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT
|
Facility
|
IP
|
$1,320.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
45386
|
| Min. Negotiated Rate |
$858.00 |
| Max. Negotiated Rate |
$1,320.00 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: ASR ASR |
$1,280.40
|
| Rate for Payer: ASR Commercial |
$1,280.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.67
|
| Rate for Payer: BCN Commercial |
$1,023.40
|
| Rate for Payer: Cash Price |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,240.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.00
|
| Rate for Payer: Healthscope Commercial |
$1,320.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,280.40
|
| Rate for Payer: Mclaren Commercial |
$1,188.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.00
|
| Rate for Payer: Nomi Health Commercial |
$1,082.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,161.60
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
45381
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$913.90 |
| Rate for Payer: Aetna Commercial |
$267.31
|
| Rate for Payer: Aetna Medicare |
$703.00
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.59
|
| Rate for Payer: Priority Health Narrow Network |
$352.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.64
|
| Rate for Payer: UHC Exchange |
$309.64
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
OP
|
$1,406.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$619.21 |
| Max. Negotiated Rate |
$1,790.62 |
| Rate for Payer: Aetna Commercial |
$1,265.40
|
| 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 |
$1,363.82
|
| Rate for Payer: ASR Commercial |
$1,363.82
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.37
|
| Rate for Payer: BCN Commercial |
$1,090.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,321.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,406.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,363.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,155.24
|
| Rate for Payer: Mclaren Commercial |
$1,265.40
|
| 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 |
$1,195.10
|
| Rate for Payer: Nomi Health Commercial |
$1,152.92
|
| 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 |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,231.94
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$985.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,237.28
|
| 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 COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Facility
|
IP
|
$1,406.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
45381
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$913.90 |
| Max. Negotiated Rate |
$1,406.00 |
| Rate for Payer: Aetna Commercial |
$1,265.40
|
| Rate for Payer: ASR ASR |
$1,363.82
|
| Rate for Payer: ASR Commercial |
$1,363.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,145.75
|
| Rate for Payer: BCN Commercial |
$1,090.07
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cofinity Commercial |
$1,321.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,124.80
|
| Rate for Payer: Healthscope Commercial |
$1,406.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,363.82
|
| Rate for Payer: Mclaren Commercial |
$1,265.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,195.10
|
| Rate for Payer: Nomi Health Commercial |
$1,152.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,237.28
|
|
|
PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST
|
Professional
|
Both
|
$1,406.00
|
|
|
Service Code
|
HCPCS 45381
|
| Min. Negotiated Rate |
$126.95 |
| Max. Negotiated Rate |
$913.90 |
| Rate for Payer: Aetna Commercial |
$267.31
|
| Rate for Payer: Aetna Medicare |
$703.00
|
| Rate for Payer: BCBS Complete |
$133.30
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$650.43
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Cash Price |
$1,124.80
|
| Rate for Payer: Meridian Medicaid |
$133.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.59
|
| Rate for Payer: Priority Health Narrow Network |
$352.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.64
|
| Rate for Payer: UHC Exchange |
$309.64
|
| Rate for Payer: UHCCP Medicaid |
$126.95
|
|
|
PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX
|
Professional
|
Both
|
$544.00
|
|
|
Service Code
|
HCPCS 45391
|
| Min. Negotiated Rate |
$162.09 |
| Max. Negotiated Rate |
$452.81 |
| Rate for Payer: Aetna Commercial |
$341.98
|
| Rate for Payer: Aetna Medicare |
$272.00
|
| Rate for Payer: BCBS Complete |
$170.19
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Cash Price |
$435.20
|
| Rate for Payer: Meridian Medicaid |
$170.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$452.81
|
| Rate for Payer: Priority Health Narrow Network |
$452.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$372.85
|
| Rate for Payer: UHC Exchange |
$372.85
|
| Rate for Payer: UHCCP Medicaid |
$162.09
|
|
|
PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS
|
Professional
|
Both
|
$1,448.00
|
|
|
Service Code
|
HCPCS 45384
|
| Hospital Charge Code |
45384
|
| Min. Negotiated Rate |
$144.20 |
| Max. Negotiated Rate |
$941.20 |
| Rate for Payer: Aetna Commercial |
$303.80
|
| Rate for Payer: Aetna Medicare |
$724.00
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$717.86
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Cash Price |
$1,158.40
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$941.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.11
|
| Rate for Payer: Priority Health Narrow Network |
$402.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.68
|
| Rate for Payer: UHC Exchange |
$340.68
|
| Rate for Payer: UHCCP Medicaid |
$144.20
|
|
