|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$2,827.44 |
| Rate for Payer: Aetna Commercial |
$92.97
|
| Rate for Payer: Aetna Medicare |
$69.38
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$69.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.44
|
| Rate for Payer: BCN Commercial |
$179.84
|
| Rate for Payer: BCN Medicare Advantage |
$69.38
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$99.91
|
| Rate for Payer: Cofinity Commercial |
$92.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.38
|
| Rate for Payer: Healthscope Commercial |
$83.26
|
| Rate for Payer: Healthscope Whirlpool |
$83.26
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.85
|
| Rate for Payer: PACE SWMI |
$69.38
|
| Rate for Payer: PHP Medicare Advantage |
$69.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.31
|
| Rate for Payer: Priority Health Medicare |
$69.38
|
| Rate for Payer: Priority Health Narrow Network |
$86.31
|
| Rate for Payer: UHC Medicare Advantage |
$71.46
|
|
|
PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$229.00
|
|
|
Service Code
|
HCPCS 11302
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$162.17 |
| Rate for Payer: Aetna Commercial |
$78.28
|
| Rate for Payer: Aetna Medicare |
$58.42
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS MAPPO |
$58.42
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$162.17
|
| Rate for Payer: BCN Medicare Advantage |
$58.42
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cash Price |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$78.28
|
| Rate for Payer: Cofinity Commercial |
$84.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.42
|
| Rate for Payer: Healthscope Commercial |
$70.10
|
| Rate for Payer: Healthscope Whirlpool |
$70.10
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.34
|
| Rate for Payer: PACE SWMI |
$58.42
|
| Rate for Payer: PHP Medicare Advantage |
$58.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.75
|
| Rate for Payer: Priority Health Medicare |
$58.42
|
| Rate for Payer: Priority Health Narrow Network |
$72.75
|
| Rate for Payer: UHC Medicare Advantage |
$60.17
|
|
|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$223.01 |
| Max. Negotiated Rate |
$788.73 |
| Rate for Payer: Aetna Commercial |
$453.08
|
| Rate for Payer: Aetna Medicare |
$338.12
|
| Rate for Payer: BCBS Complete |
$234.16
|
| Rate for Payer: BCBS MAPPO |
$338.12
|
| Rate for Payer: BCBS Trust/PPO |
$782.41
|
| Rate for Payer: BCN Commercial |
$788.73
|
| Rate for Payer: BCN Medicare Advantage |
$338.12
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$486.89
|
| Rate for Payer: Cofinity Commercial |
$453.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.12
|
| Rate for Payer: Healthscope Commercial |
$405.74
|
| Rate for Payer: Healthscope Whirlpool |
$405.74
|
| Rate for Payer: Meridian Medicaid |
$234.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$355.03
|
| Rate for Payer: PACE SWMI |
$338.12
|
| Rate for Payer: PHP Medicare Advantage |
$338.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.73
|
| Rate for Payer: Priority Health Medicare |
$338.12
|
| Rate for Payer: Priority Health Narrow Network |
$609.73
|
| Rate for Payer: UHC Medicare Advantage |
$348.26
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,001.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$170.19 |
| Max. Negotiated Rate |
$700.70 |
| Rate for Payer: Aetna Commercial |
$343.70
|
| Rate for Payer: Aetna Medicare |
$256.49
|
| Rate for Payer: BCBS Complete |
$178.70
|
| Rate for Payer: BCBS MAPPO |
$256.49
|
| Rate for Payer: BCBS Trust/PPO |
$395.70
|
| Rate for Payer: BCN Commercial |
$639.67
|
| Rate for Payer: BCN Medicare Advantage |
$256.49
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cash Price |
$800.80
|
| Rate for Payer: Cofinity Commercial |
$369.35
|
| Rate for Payer: Cofinity Commercial |
$343.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.49
|
| Rate for Payer: Healthscope Commercial |
$307.79
|
| Rate for Payer: Healthscope Whirlpool |
$307.79
|
| Rate for Payer: Meridian Medicaid |
$178.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$269.31
|
| Rate for Payer: PACE SWMI |
$256.49
|
| Rate for Payer: PHP Medicare Advantage |
$256.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.91
|
| Rate for Payer: Priority Health Medicare |
$256.49
|
| Rate for Payer: Priority Health Narrow Network |
$463.91
|
| Rate for Payer: UHC Medicare Advantage |
$264.18
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$345.01 |
| Rate for Payer: Aetna Commercial |
$216.97
|
| Rate for Payer: Aetna Medicare |
$161.92
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$237.74
|
| Rate for Payer: BCN Commercial |
$345.01
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cofinity Commercial |
$216.97
|
| Rate for Payer: Cofinity Commercial |
$233.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$194.30
|
| Rate for Payer: Healthscope Whirlpool |
$194.30
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.22
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health Narrow Network |
$292.22
|
| Rate for Payer: UHC Medicare Advantage |
$166.78
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$515.20 |
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.20
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$741.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$3,394.35 |
| Rate for Payer: Aetna Commercial |
$209.23
|
| Rate for Payer: Aetna Medicare |
$156.14
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$156.14
|
| Rate for Payer: BCBS Trust/PPO |
$333.36
|
| Rate for Payer: BCN Commercial |
$3,394.35
|
| Rate for Payer: BCN Medicare Advantage |
$156.14
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cash Price |
$592.80
|
| Rate for Payer: Cofinity Commercial |
$224.84
|
| Rate for Payer: Cofinity Commercial |
$209.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.14
|
| Rate for Payer: Healthscope Commercial |
$187.37
|
| Rate for Payer: Healthscope Whirlpool |
$187.37
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$163.95
|
| Rate for Payer: PACE SWMI |
$156.14
|
| Rate for Payer: PHP Medicare Advantage |
$156.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$518.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$277.53
|
| Rate for Payer: Priority Health Medicare |
$156.14
|
| Rate for Payer: Priority Health Narrow Network |
$277.53
|
| Rate for Payer: UHC Medicare Advantage |
$160.82
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$654.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$727.15 |
| Rate for Payer: Aetna Commercial |
$153.08
|
| Rate for Payer: Aetna Medicare |
$114.24
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cash Price |
$523.20
|
| Rate for Payer: Cofinity Commercial |
$164.51
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Healthscope Commercial |
$137.09
|
| Rate for Payer: Healthscope Whirlpool |
$137.09
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.44
|
| Rate for Payer: Priority Health Medicare |
$114.24
|
| Rate for Payer: Priority Health Narrow Network |
$203.44
|
| Rate for Payer: UHC Medicare Advantage |
$117.67
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$239.85 |
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: Aetna Medicare |
$54.45
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$54.45
|
| Rate for Payer: BCBS Trust/PPO |
$239.85
|
| Rate for Payer: BCN Commercial |
$219.89
|
| Rate for Payer: BCN Medicare Advantage |
$54.45
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$78.41
|
| Rate for Payer: Cofinity Commercial |
$72.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.45
|
| Rate for Payer: Healthscope Commercial |
$65.34
|
| Rate for Payer: Healthscope Whirlpool |
$65.34
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.17
|
| Rate for Payer: PACE SWMI |
$54.45
|
| Rate for Payer: PHP Medicare Advantage |
$54.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.60
|
| Rate for Payer: Priority Health Medicare |
$54.45
|
| Rate for Payer: Priority Health Narrow Network |
$97.60
|
| Rate for Payer: UHC Medicare Advantage |
$56.08
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$244.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$239.85 |
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: Aetna Medicare |
$54.45
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$54.45
|
| Rate for Payer: BCBS Trust/PPO |
$239.85
|
| Rate for Payer: BCN Commercial |
$219.89
|
| Rate for Payer: BCN Medicare Advantage |
$54.45
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$78.41
|
| Rate for Payer: Cofinity Commercial |
$72.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.45
|
| Rate for Payer: Healthscope Commercial |
$65.34
|
| Rate for Payer: Healthscope Whirlpool |
$65.34
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.17
|
| Rate for Payer: PACE SWMI |
$54.45
|
| Rate for Payer: PHP Medicare Advantage |
$54.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.60
|
| Rate for Payer: Priority Health Medicare |
$54.45
|
| Rate for Payer: Priority Health Narrow Network |
$97.60
|
| Rate for Payer: UHC Medicare Advantage |
$56.08
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$170.80 |
| Max. Negotiated Rate |
$1,015.50 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: Aetna Medicare |
$812.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: ASR ASR |
$236.68
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$189.17
|
| Rate for Payer: BCN Commercial |
$189.17
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$229.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$244.00
|
| Rate for Payer: Healthscope Whirlpool |
$236.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$812.40
|
| Rate for Payer: Mclaren Commercial |
$219.60
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$893.64
|
| Rate for Payer: PHP Medicaid |
$444.38
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$819.92
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$655.94
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.72
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: VA VA |
$812.40
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$170.80 |
| Max. Negotiated Rate |
$244.00 |
| Rate for Payer: Aetna Commercial |
$219.60
|
| Rate for Payer: ASR ASR |
$236.68
|
| Rate for Payer: BCBS Trust/PPO |
$189.17
|
| Rate for Payer: BCN Commercial |
$189.17
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$229.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Healthscope Commercial |
$244.00
|
| Rate for Payer: Healthscope Whirlpool |
$236.68
|
| Rate for Payer: Mclaren Commercial |
$219.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.72
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$291.09 |
| Rate for Payer: Aetna Commercial |
$160.60
|
| Rate for Payer: Aetna Medicare |
$119.85
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$119.85
|
| Rate for Payer: BCBS Trust/PPO |
$291.09
|
| Rate for Payer: BCN Commercial |
$177.39
|
| Rate for Payer: BCN Medicare Advantage |
$119.85
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$172.58
|
| Rate for Payer: Cofinity Commercial |
$160.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.85
|
| Rate for Payer: Healthscope Commercial |
$143.82
|
| Rate for Payer: Healthscope Whirlpool |
$143.82
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.84
|
| Rate for Payer: PACE SWMI |
$119.85
|
| Rate for Payer: PHP Medicare Advantage |
$119.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.43
|
| Rate for Payer: Priority Health Medicare |
$119.85
|
| Rate for Payer: Priority Health Narrow Network |
$213.43
|
| Rate for Payer: UHC Medicare Advantage |
$123.45
|
|
|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$364.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$265.17 |
| Rate for Payer: Aetna Commercial |
$199.89
|
| Rate for Payer: Aetna Medicare |
$149.17
|
| Rate for Payer: BCBS Complete |
$101.77
|
| Rate for Payer: BCBS MAPPO |
$149.17
|
| Rate for Payer: BCBS Trust/PPO |
$118.87
|
| Rate for Payer: BCN Commercial |
$220.39
|
| Rate for Payer: BCN Medicare Advantage |
$149.17
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cash Price |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$214.80
|
| Rate for Payer: Cofinity Commercial |
$199.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.17
|
| Rate for Payer: Healthscope Commercial |
$179.00
|
| Rate for Payer: Healthscope Whirlpool |
$179.00
|
| Rate for Payer: Meridian Medicaid |
$101.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$156.63
|
| Rate for Payer: PACE SWMI |
$149.17
|
| Rate for Payer: PHP Medicare Advantage |
$149.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.17
|
| Rate for Payer: Priority Health Medicare |
$149.17
|
| Rate for Payer: Priority Health Narrow Network |
$265.17
|
| Rate for Payer: UHC Medicare Advantage |
$153.65
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 45340
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$675.35 |
| Rate for Payer: Aetna Commercial |
$101.96
|
| Rate for Payer: Aetna Medicare |
$76.09
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$76.09
|
| Rate for Payer: BCBS Trust/PPO |
$96.68
|
| Rate for Payer: BCN Commercial |
$675.35
|
| Rate for Payer: BCN Medicare Advantage |
$76.09
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$109.57
|
| Rate for Payer: Cofinity Commercial |
$101.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.09
|
| Rate for Payer: Healthscope Commercial |
$91.31
|
| Rate for Payer: Healthscope Whirlpool |
$91.31
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.89
|
| Rate for Payer: PACE SWMI |
$76.09
|
| Rate for Payer: PHP Medicare Advantage |
$76.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.82
|
| Rate for Payer: Priority Health Medicare |
$76.09
|
| Rate for Payer: Priority Health Narrow Network |
$135.82
|
| Rate for Payer: UHC Medicare Advantage |
$78.37
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 45342
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$553.70 |
| Rate for Payer: Aetna Commercial |
$222.71
|
| Rate for Payer: Aetna Medicare |
$166.20
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$166.20
|
| Rate for Payer: BCBS Trust/PPO |
$269.43
|
| Rate for Payer: BCN Commercial |
$245.32
|
| Rate for Payer: BCN Medicare Advantage |
$166.20
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$239.33
|
| Rate for Payer: Cofinity Commercial |
$222.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.20
|
| Rate for Payer: Healthscope Commercial |
$199.44
|
| Rate for Payer: Healthscope Whirlpool |
$199.44
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.51
|
| Rate for Payer: PACE SWMI |
$166.20
|
| Rate for Payer: PHP Medicare Advantage |
$166.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.16
|
| Rate for Payer: Priority Health Medicare |
$166.20
|
| Rate for Payer: Priority Health Narrow Network |
$295.16
|
| Rate for Payer: UHC Medicare Advantage |
$171.19
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$336.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$1,015.50 |
| Rate for Payer: Aetna Commercial |
$302.40
|
| Rate for Payer: Aetna Medicare |
$812.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
| Rate for Payer: ASR ASR |
$325.92
|
| Rate for Payer: BCBS Complete |
$466.64
|
| Rate for Payer: BCBS MAPPO |
$812.40
|
| Rate for Payer: BCBS Trust/PPO |
$260.50
|
| Rate for Payer: BCN Commercial |
$260.50
|
| Rate for Payer: BCN Medicare Advantage |
$812.40
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$315.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
| Rate for Payer: Healthscope Commercial |
$336.00
|
| Rate for Payer: Healthscope Whirlpool |
$325.92
|
| Rate for Payer: Humana Choice PPO Medicare |
$812.40
|
| Rate for Payer: Mclaren Commercial |
$302.40
|
| Rate for Payer: Mclaren Medicaid |
$444.38
|
| Rate for Payer: Mclaren Medicare |
$812.40
|
| Rate for Payer: Meridian Medicaid |
$466.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$285.60
|
| Rate for Payer: PACE Medicare |
$771.78
|
| Rate for Payer: PACE SWMI |
$812.40
|
| Rate for Payer: PHP Commercial |
$893.64
|
| Rate for Payer: PHP Medicaid |
$444.38
|
| Rate for Payer: PHP Medicare Advantage |
$812.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.76
|
| Rate for Payer: Priority Health Medicare |
$812.40
|
| Rate for Payer: Priority Health Narrow Network |
$238.56
|
| Rate for Payer: Railroad Medicare Medicare |
$812.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.68
|
| Rate for Payer: UHC Medicare Advantage |
$836.77
|
| Rate for Payer: VA VA |
$812.40
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$421.73 |
| Rate for Payer: Aetna Commercial |
$93.36
|
| Rate for Payer: Aetna Medicare |
$69.67
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$69.67
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$421.73
|
| Rate for Payer: BCN Medicare Advantage |
$69.67
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$100.32
|
| Rate for Payer: Cofinity Commercial |
$93.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.67
|
| Rate for Payer: Healthscope Commercial |
$83.60
|
| Rate for Payer: Healthscope Whirlpool |
$83.60
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.15
|
| Rate for Payer: PACE SWMI |
$69.67
|
| Rate for Payer: PHP Medicare Advantage |
$69.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.65
|
| Rate for Payer: Priority Health Medicare |
$69.67
|
| Rate for Payer: Priority Health Narrow Network |
$124.65
|
| Rate for Payer: UHC Medicare Advantage |
$71.76
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$421.73 |
| Rate for Payer: Aetna Commercial |
$93.36
|
| Rate for Payer: Aetna Medicare |
$69.67
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$69.67
|
| Rate for Payer: BCBS Trust/PPO |
$302.72
|
| Rate for Payer: BCN Commercial |
$421.73
|
| Rate for Payer: BCN Medicare Advantage |
$69.67
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$93.36
|
| Rate for Payer: Cofinity Commercial |
$100.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.67
|
| Rate for Payer: Healthscope Commercial |
$83.60
|
| Rate for Payer: Healthscope Whirlpool |
$83.60
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.15
|
| Rate for Payer: PACE SWMI |
$69.67
|
| Rate for Payer: PHP Medicare Advantage |
$69.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.65
|
| Rate for Payer: Priority Health Medicare |
$69.67
|
| Rate for Payer: Priority Health Narrow Network |
$124.65
|
| Rate for Payer: UHC Medicare Advantage |
$71.76
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$336.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$336.00 |
| Rate for Payer: Aetna Commercial |
$302.40
|
| Rate for Payer: ASR ASR |
$325.92
|
| Rate for Payer: BCBS Trust/PPO |
$260.50
|
| Rate for Payer: BCN Commercial |
$260.50
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$315.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.80
|
| Rate for Payer: Healthscope Commercial |
$336.00
|
| Rate for Payer: Healthscope Whirlpool |
$325.92
|
| Rate for Payer: Mclaren Commercial |
$302.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$285.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$295.68
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$991.04 |
| Rate for Payer: Aetna Commercial |
$130.89
|
| Rate for Payer: Aetna Medicare |
$97.68
|
| Rate for Payer: BCBS Complete |
$67.10
|
| Rate for Payer: BCBS MAPPO |
$97.68
|
| Rate for Payer: BCBS Trust/PPO |
$383.02
|
| Rate for Payer: BCN Commercial |
$991.04
|
| Rate for Payer: BCN Medicare Advantage |
$97.68
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cofinity Commercial |
$130.89
|
| Rate for Payer: Cofinity Commercial |
$140.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.68
|
| Rate for Payer: Healthscope Commercial |
$117.22
|
| Rate for Payer: Healthscope Whirlpool |
$117.22
|
| Rate for Payer: Meridian Medicaid |
$67.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.56
|
| Rate for Payer: PACE SWMI |
$97.68
|
| Rate for Payer: PHP Medicare Advantage |
$97.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$174.05
|
| Rate for Payer: Priority Health Medicare |
$97.68
|
| Rate for Payer: Priority Health Narrow Network |
$174.05
|
| Rate for Payer: UHC Medicare Advantage |
$100.61
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 45332
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$407.06 |
| Rate for Payer: Aetna Commercial |
$136.25
|
| Rate for Payer: Aetna Medicare |
$101.68
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$101.68
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$407.06
|
| Rate for Payer: BCN Medicare Advantage |
$101.68
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$136.25
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.68
|
| Rate for Payer: Healthscope Commercial |
$122.02
|
| Rate for Payer: Healthscope Whirlpool |
$122.02
|
| Rate for Payer: Meridian Medicaid |
$70.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.76
|
| Rate for Payer: PACE SWMI |
$101.68
|
| Rate for Payer: PHP Medicare Advantage |
$101.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.09
|
| Rate for Payer: Priority Health Medicare |
$101.68
|
| Rate for Payer: Priority Health Narrow Network |
$181.09
|
| Rate for Payer: UHC Medicare Advantage |
$104.73
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$407.06 |
| Rate for Payer: Aetna Commercial |
$136.25
|
| Rate for Payer: Aetna Medicare |
$101.68
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$101.68
|
| Rate for Payer: BCBS Trust/PPO |
$147.92
|
| Rate for Payer: BCN Commercial |
$407.06
|
| Rate for Payer: BCN Medicare Advantage |
$101.68
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Cofinity Commercial |
$136.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.68
|
| Rate for Payer: Healthscope Commercial |
$122.02
|
| Rate for Payer: Healthscope Whirlpool |
$122.02
|
| Rate for Payer: Meridian Medicaid |
$70.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.76
|
| Rate for Payer: PACE SWMI |
$101.68
|
| Rate for Payer: PHP Medicare Advantage |
$101.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.09
|
| Rate for Payer: Priority Health Medicare |
$101.68
|
| Rate for Payer: Priority Health Narrow Network |
$181.09
|
| Rate for Payer: UHC Medicare Advantage |
$104.73
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$1,311.18 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: ASR ASR |
$494.70
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$395.40
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$479.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$510.00
|
| Rate for Payer: Healthscope Whirlpool |
$494.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$362.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
45332
|
| Min. Negotiated Rate |
$357.00 |
| Max. Negotiated Rate |
$510.00 |
| Rate for Payer: Aetna Commercial |
$459.00
|
| Rate for Payer: ASR ASR |
$494.70
|
| Rate for Payer: BCBS Trust/PPO |
$395.40
|
| Rate for Payer: BCN Commercial |
$395.40
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$479.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$510.00
|
| Rate for Payer: Healthscope Whirlpool |
$494.70
|
| Rate for Payer: Mclaren Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.80
|
|
