|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN
|
Professional
|
Both
|
$3,149.00
|
|
|
Service Code
|
HCPCS 36475
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$2,046.85 |
| Rate for Payer: Aetna Commercial |
$374.63
|
| Rate for Payer: Aetna Medicare |
$1,574.50
|
| Rate for Payer: BCBS Complete |
$182.50
|
| Rate for Payer: BCBS Trust/PPO |
$621.81
|
| Rate for Payer: BCN Commercial |
$1,586.74
|
| Rate for Payer: Cash Price |
$2,519.20
|
| Rate for Payer: Cash Price |
$2,519.20
|
| Rate for Payer: Meridian Medicaid |
$182.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,046.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.43
|
| Rate for Payer: Priority Health Narrow Network |
$433.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$462.74
|
| Rate for Payer: UHC Exchange |
$462.74
|
| Rate for Payer: UHCCP Medicaid |
$173.81
|
|
|
PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 36476
|
| Min. Negotiated Rate |
$83.71 |
| Max. Negotiated Rate |
$510.87 |
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Medicare |
$163.00
|
| Rate for Payer: BCBS Complete |
$87.90
|
| Rate for Payer: BCBS Trust/PPO |
$510.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Meridian Medicaid |
$87.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.41
|
| Rate for Payer: Priority Health Narrow Network |
$207.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.48
|
| Rate for Payer: UHC Exchange |
$227.48
|
| Rate for Payer: UHCCP Medicaid |
$83.71
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 44121
|
| Min. Negotiated Rate |
$152.72 |
| Max. Negotiated Rate |
$1,080.90 |
| Rate for Payer: Aetna Commercial |
$326.50
|
| Rate for Payer: Aetna Medicare |
$829.50
|
| Rate for Payer: BCBS Complete |
$160.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,080.90
|
| Rate for Payer: BCN Commercial |
$348.43
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Meridian Medicaid |
$160.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,078.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.57
|
| Rate for Payer: Priority Health Narrow Network |
$426.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$299.23
|
| Rate for Payer: UHC Exchange |
$299.23
|
| Rate for Payer: UHCCP Medicaid |
$152.72
|
|
|
PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY
|
Professional
|
Both
|
$3,497.00
|
|
|
Service Code
|
HCPCS 44125
|
| Min. Negotiated Rate |
$754.02 |
| Max. Negotiated Rate |
$2,273.05 |
| Rate for Payer: Aetna Commercial |
$1,588.54
|
| Rate for Payer: Aetna Medicare |
$1,748.50
|
| Rate for Payer: BCBS Complete |
$791.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.51
|
| Rate for Payer: BCN Commercial |
$1,708.91
|
| Rate for Payer: Cash Price |
$2,797.60
|
| Rate for Payer: Cash Price |
$2,797.60
|
| Rate for Payer: Meridian Medicaid |
$791.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$754.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,273.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,100.01
|
| Rate for Payer: Priority Health Narrow Network |
$2,100.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,428.06
|
| Rate for Payer: UHC Exchange |
$1,428.06
|
| Rate for Payer: UHCCP Medicaid |
$754.02
|
|
|
PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS
|
Professional
|
Both
|
$2,877.00
|
|
|
Service Code
|
HCPCS 51960
|
| Min. Negotiated Rate |
$881.61 |
| Max. Negotiated Rate |
$2,191.65 |
| Rate for Payer: Aetna Commercial |
$1,776.46
|
| Rate for Payer: Aetna Medicare |
$1,438.50
|
| Rate for Payer: BCBS Complete |
$925.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.99
|
| Rate for Payer: BCN Commercial |
$1,988.43
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Cash Price |
$2,301.60
|
| Rate for Payer: Meridian Medicaid |
$925.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,870.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,191.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,191.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,678.15
|
| Rate for Payer: UHC Exchange |
$1,678.15
|
| Rate for Payer: UHCCP Medicaid |
$881.61
|
|
|
PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX
|
Professional
|
Both
|
$3,172.00
|
|
|
Service Code
|
HCPCS 44130
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$2,351.77 |
| Rate for Payer: Aetna Commercial |
$1,773.78
|
| Rate for Payer: Aetna Medicare |
$1,586.00
|
| Rate for Payer: BCBS Complete |
$887.44
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,916.10
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Cash Price |
$2,537.60
|
| Rate for Payer: Meridian Medicaid |
$887.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$845.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,061.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,351.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,570.28
|
| Rate for Payer: UHC Exchange |
$1,570.28
|
| Rate for Payer: UHCCP Medicaid |
$845.18
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
IP
|
$2,816.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,830.40 |
| Max. Negotiated Rate |
$2,816.00 |
| Rate for Payer: Aetna Commercial |
$2,534.40
|
| Rate for Payer: ASR ASR |
$2,731.52
|
| Rate for Payer: ASR Commercial |
$2,731.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.76
|
| Rate for Payer: BCN Commercial |
$2,183.24
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$2,647.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,252.80
|
| Rate for Payer: Healthscope Commercial |
$2,816.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,731.52
|
| Rate for Payer: Mclaren Commercial |
$2,534.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,393.60
|
| Rate for Payer: Nomi Health Commercial |
$2,309.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,478.08
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
44005
|
| Min. Negotiated Rate |
$700.56 |
| Max. Negotiated Rate |
$1,951.45 |
| Rate for Payer: Aetna Commercial |
$1,475.02
|
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: BCBS Complete |
$735.59
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Meridian Medicaid |
$735.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$700.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,951.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,951.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,322.38
|
| Rate for Payer: UHC Exchange |
$1,322.38
|
| Rate for Payer: UHCCP Medicaid |
$700.56
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Professional
|
Both
|
$2,816.00
|
|
|
Service Code
|
HCPCS 44005
|
| Min. Negotiated Rate |
$700.56 |
| Max. Negotiated Rate |
$1,951.45 |
| Rate for Payer: Aetna Commercial |
$1,475.02
|
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: BCBS Complete |
$735.59
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$1,590.16
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Meridian Medicaid |
$735.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$700.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,951.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,951.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,322.38
|
| Rate for Payer: UHC Exchange |
$1,322.38
|
| Rate for Payer: UHCCP Medicaid |
$700.56
|
|
|
PR ENTEROLSS FRING INTSTINAL ADHESION SPX
|
Facility
|
OP
|
$2,816.00
|
|
|
Service Code
|
CPT 44005
|
| Hospital Charge Code |
44005
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$2,816.00 |
| Rate for Payer: Aetna Commercial |
$2,534.40
|
| Rate for Payer: Aetna Medicare |
$1,408.00
|
| Rate for Payer: ASR ASR |
$2,731.52
|
| Rate for Payer: ASR Commercial |
$2,731.52
|
| Rate for Payer: BCBS Complete |
$1,126.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,306.02
|
| Rate for Payer: BCN Commercial |
$2,183.24
|
| Rate for Payer: Cash Price |
$2,252.80
|
| Rate for Payer: Cofinity Commercial |
$2,647.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,252.80
|
| Rate for Payer: Healthscope Commercial |
$2,816.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,731.52
|
| Rate for Payer: Mclaren Commercial |
$2,534.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,393.60
|
| Rate for Payer: Nomi Health Commercial |
$2,309.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,830.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,467.38
|
| Rate for Payer: Priority Health Narrow Network |
$1,974.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,478.08
|
|
|
PR ENTERORRHAPHY MULTIPLE PERFORATIONS
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 44603
|
| Min. Negotiated Rate |
$220.30 |
| Max. Negotiated Rate |
$2,879.76 |
| Rate for Payer: Aetna Commercial |
$2,183.13
|
| Rate for Payer: Aetna Medicare |
$1,540.50
|
| Rate for Payer: BCBS Complete |
$1,085.15
|
| Rate for Payer: BCBS Trust/PPO |
$220.30
|
| Rate for Payer: BCN Commercial |
$2,349.07
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Meridian Medicaid |
$1,085.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,033.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,879.76
|
| Rate for Payer: Priority Health Narrow Network |
$2,879.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,948.93
|
| Rate for Payer: UHC Exchange |
$1,948.93
|
| Rate for Payer: UHCCP Medicaid |
$1,033.48
|
|
|
PR ENTERORRHAPHY SINGLE PERFORATION
|
Professional
|
Both
|
$2,425.00
|
|
|
Service Code
|
HCPCS 44602
|
| Min. Negotiated Rate |
$898.01 |
| Max. Negotiated Rate |
$2,506.30 |
| Rate for Payer: Aetna Commercial |
$1,903.43
|
| Rate for Payer: Aetna Medicare |
$1,212.50
|
| Rate for Payer: BCBS Complete |
$942.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.39
|
| Rate for Payer: BCN Commercial |
$2,046.09
|
| Rate for Payer: Cash Price |
$1,940.00
|
| Rate for Payer: Cash Price |
$1,940.00
|
| Rate for Payer: Meridian Medicaid |
$942.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$898.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,506.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,700.79
|
| Rate for Payer: UHC Exchange |
$1,700.79
|
| Rate for Payer: UHCCP Medicaid |
$898.01
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,136.00
|
|
|
Service Code
|
HCPCS 44377
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$1,573.28 |
| Rate for Payer: Aetna Commercial |
$397.53
|
| Rate for Payer: Aetna Medicare |
$568.00
|
| Rate for Payer: BCBS Complete |
$196.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.28
|
| Rate for Payer: BCN Commercial |
$428.57
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Cash Price |
$908.80
|
| Rate for Payer: Meridian Medicaid |
$196.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$738.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$525.59
|
| Rate for Payer: Priority Health Narrow Network |
$525.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$405.86
|
| Rate for Payer: UHC Exchange |
$405.86
|
| Rate for Payer: UHCCP Medicaid |
$187.44
|
|
|
PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 44376
|
| Min. Negotiated Rate |
$178.71 |
| Max. Negotiated Rate |
$1,925.65 |
| Rate for Payer: Aetna Commercial |
$377.32
|
| Rate for Payer: Aetna Medicare |
$518.00
|
| Rate for Payer: BCBS Complete |
$187.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,925.65
|
| Rate for Payer: BCN Commercial |
$406.58
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Meridian Medicaid |
$187.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.15
|
| Rate for Payer: Priority Health Narrow Network |
$498.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$383.66
|
| Rate for Payer: UHC Exchange |
$383.66
|
| Rate for Payer: UHCCP Medicaid |
$178.71
|
|
|
PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 44369
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$728.00 |
| Rate for Payer: Aetna Commercial |
$326.36
|
| Rate for Payer: Aetna Medicare |
$560.00
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS Trust/PPO |
$593.28
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$431.34
|
| Rate for Payer: Priority Health Narrow Network |
$431.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$334.70
|
| Rate for Payer: UHC Exchange |
$334.70
|
| Rate for Payer: UHCCP Medicaid |
$154.43
|
|
|
PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE
|
Professional
|
Both
|
$922.00
|
|
|
Service Code
|
HCPCS 44373
|
| Min. Negotiated Rate |
$121.41 |
| Max. Negotiated Rate |
$1,809.96 |
| Rate for Payer: Aetna Commercial |
$255.47
|
| Rate for Payer: Aetna Medicare |
$461.00
|
| Rate for Payer: BCBS Complete |
$127.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.96
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Meridian Medicaid |
$127.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$336.48
|
| Rate for Payer: Priority Health Narrow Network |
$336.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.81
|
| Rate for Payer: UHC Exchange |
$258.81
|
| Rate for Payer: UHCCP Medicaid |
$121.41
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
IP
|
$1,548.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$1,006.20 |
| Max. Negotiated Rate |
$1,548.00 |
| Rate for Payer: Aetna Commercial |
$1,393.20
|
| Rate for Payer: ASR ASR |
$1,501.56
|
| Rate for Payer: ASR Commercial |
$1,501.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,261.47
|
| Rate for Payer: BCN Commercial |
$1,200.16
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,455.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Healthscope Commercial |
$1,548.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,501.56
|
| Rate for Payer: Mclaren Commercial |
$1,393.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,315.80
|
| Rate for Payer: Nomi Health Commercial |
$1,269.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,362.24
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$241.33 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$511.57
|
| Rate for Payer: Aetna Medicare |
$774.00
|
| Rate for Payer: BCBS Complete |
$253.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$549.76
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Meridian Medicaid |
$253.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.74
|
| Rate for Payer: Priority Health Narrow Network |
$674.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$520.46
|
| Rate for Payer: UHC Exchange |
$520.46
|
| Rate for Payer: UHCCP Medicaid |
$241.33
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Facility
|
OP
|
$1,548.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
44378
|
| Min. Negotiated Rate |
$996.23 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$1,393.20
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$1,501.56
|
| Rate for Payer: ASR Commercial |
$1,501.56
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.66
|
| Rate for Payer: BCN Commercial |
$1,200.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cofinity Commercial |
$1,455.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,548.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,501.56
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$1,393.20
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,315.80
|
| Rate for Payer: Nomi Health Commercial |
$1,269.36
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,356.36
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,085.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,362.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING
|
Professional
|
Both
|
$1,548.00
|
|
|
Service Code
|
HCPCS 44378
|
| Min. Negotiated Rate |
$241.33 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$511.57
|
| Rate for Payer: Aetna Medicare |
$774.00
|
| Rate for Payer: BCBS Complete |
$253.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$549.76
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Cash Price |
$1,238.40
|
| Rate for Payer: Meridian Medicaid |
$253.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$674.74
|
| Rate for Payer: Priority Health Narrow Network |
$674.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$520.46
|
| Rate for Payer: UHC Exchange |
$520.46
|
| Rate for Payer: UHCCP Medicaid |
$241.33
|
|
|
PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 44370
|
| Min. Negotiated Rate |
$167.84 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$352.95
|
| Rate for Payer: Aetna Medicare |
$692.00
|
| Rate for Payer: BCBS Complete |
$176.23
|
| Rate for Payer: BCBS Trust/PPO |
$316.98
|
| Rate for Payer: BCN Commercial |
$382.15
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Meridian Medicaid |
$176.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.51
|
| Rate for Payer: Priority Health Narrow Network |
$469.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$360.19
|
| Rate for Payer: UHC Exchange |
$360.19
|
| Rate for Payer: UHCCP Medicaid |
$167.84
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING
|
Professional
|
Both
|
$1,318.00
|
|
|
Service Code
|
HCPCS 44366
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$856.70 |
| Rate for Payer: Aetna Commercial |
$318.57
|
| Rate for Payer: Aetna Medicare |
$659.00
|
| Rate for Payer: BCBS Complete |
$158.34
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: Cash Price |
$1,054.40
|
| Rate for Payer: Cash Price |
$1,054.40
|
| Rate for Payer: Meridian Medicaid |
$158.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.20
|
| Rate for Payer: Priority Health Narrow Network |
$421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$327.80
|
| Rate for Payer: UHC Exchange |
$327.80
|
| Rate for Payer: UHCCP Medicaid |
$150.80
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT
|
Professional
|
Both
|
$1,532.00
|
|
|
Service Code
|
HCPCS 44379
|
| Min. Negotiated Rate |
$256.88 |
| Max. Negotiated Rate |
$1,943.09 |
| Rate for Payer: Aetna Commercial |
$543.16
|
| Rate for Payer: Aetna Medicare |
$766.00
|
| Rate for Payer: BCBS Complete |
$269.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.09
|
| Rate for Payer: BCN Commercial |
$584.95
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Meridian Medicaid |
$269.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.50
|
| Rate for Payer: Priority Health Narrow Network |
$719.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$549.60
|
| Rate for Payer: UHC Exchange |
$549.60
|
| Rate for Payer: UHCCP Medicaid |
$256.88
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE
|
Professional
|
Both
|
$940.00
|
|
|
Service Code
|
HCPCS 44372
|
| Min. Negotiated Rate |
$151.23 |
| Max. Negotiated Rate |
$611.00 |
| Rate for Payer: Aetna Commercial |
$318.37
|
| Rate for Payer: Aetna Medicare |
$470.00
|
| Rate for Payer: BCBS Complete |
$158.79
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$343.05
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Meridian Medicaid |
$158.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.20
|
| Rate for Payer: Priority Health Narrow Network |
$421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$321.38
|
| Rate for Payer: UHC Exchange |
$321.38
|
| Rate for Payer: UHCCP Medicaid |
$151.23
|
|
|
PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$974.00
|
|
|
Service Code
|
HCPCS 44363
|
| Min. Negotiated Rate |
$120.56 |
| Max. Negotiated Rate |
$633.10 |
| Rate for Payer: Aetna Commercial |
$254.46
|
| Rate for Payer: Aetna Medicare |
$487.00
|
| Rate for Payer: BCBS Complete |
$126.59
|
| Rate for Payer: BCBS Trust/PPO |
$283.17
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Cash Price |
$779.20
|
| Rate for Payer: Meridian Medicaid |
$126.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.07
|
| Rate for Payer: Priority Health Narrow Network |
$337.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.75
|
| Rate for Payer: UHC Exchange |
$258.75
|
| Rate for Payer: UHCCP Medicaid |
$120.56
|
|
