|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$128.70 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna Commercial |
$178.20
|
| Rate for Payer: ASR ASR |
$192.06
|
| Rate for Payer: ASR Commercial |
$192.06
|
| Rate for Payer: BCBS Trust/PPO |
$161.35
|
| Rate for Payer: BCN Commercial |
$153.51
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$186.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Healthscope Commercial |
$198.00
|
| Rate for Payer: Healthscope Whirlpool |
$192.06
|
| Rate for Payer: Mclaren Commercial |
$178.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: Nomi Health Commercial |
$162.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.24
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$48.82
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Healthscope Commercial |
$58.58
|
| Rate for Payer: Healthscope Whirlpool |
$58.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
| Rate for Payer: UHCCP DNSP |
$48.82
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 11301
|
| Hospital Charge Code |
11301
|
| Min. Negotiated Rate |
$48.82 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Aetna Commercial |
$65.42
|
| Rate for Payer: Aetna Medicare |
$48.82
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$48.82
|
| Rate for Payer: BCN Medicare Advantage |
$48.82
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$65.42
|
| Rate for Payer: Cofinity Commercial |
$70.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.82
|
| Rate for Payer: Healthscope Commercial |
$58.58
|
| Rate for Payer: Healthscope Whirlpool |
$58.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.26
|
| Rate for Payer: Nomi Health Commercial |
$58.58
|
| Rate for Payer: PACE SWMI |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$48.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.82
|
| Rate for Payer: UHC Medicare Advantage |
$48.82
|
| Rate for Payer: UHCCP DNSP |
$48.82
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$198.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
11301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$300.37 |
| Rate for Payer: Aetna Commercial |
$178.20
|
| Rate for Payer: Aetna Medicare |
$193.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: ASR ASR |
$192.06
|
| Rate for Payer: ASR Commercial |
$192.06
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCBS Trust/PPO |
$162.14
|
| Rate for Payer: BCN Commercial |
$153.51
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$186.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$198.00
|
| Rate for Payer: Healthscope Whirlpool |
$192.06
|
| Rate for Payer: Humana Choice PPO Medicare |
$193.79
|
| Rate for Payer: Mclaren Commercial |
$178.20
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.30
|
| Rate for Payer: Nomi Health Commercial |
$162.36
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$213.17
|
| Rate for Payer: PHP Medicaid |
$103.87
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.49
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health Narrow Network |
$138.80
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$300.37
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP DNSP |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: VA VA |
$193.79
|
|
|
PR SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM
|
Professional
|
Both
|
$257.00
|
|
|
Service Code
|
HCPCS 11303
|
| Min. Negotiated Rate |
$67.93 |
| Max. Negotiated Rate |
$167.05 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$67.93
|
| Rate for Payer: BCBS Complete |
$102.80
|
| Rate for Payer: BCBS MAPPO |
$67.93
|
| Rate for Payer: BCN Medicare Advantage |
$67.93
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cash Price |
$205.60
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Cofinity Commercial |
$91.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.93
|
| Rate for Payer: Healthscope Commercial |
$81.52
|
| Rate for Payer: Healthscope Whirlpool |
$81.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.33
|
| Rate for Payer: Nomi Health Commercial |
$81.52
|
| Rate for Payer: PACE SWMI |
$67.93
|
| Rate for Payer: PHP Medicare Advantage |
$67.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.05
|
| Rate for Payer: Priority Health Medicare |
$67.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.93
|
| Rate for Payer: UHC Medicare Advantage |
$67.93
|
| Rate for Payer: UHCCP DNSP |
$67.93
|
|
|
PR SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 11302
|
| Min. Negotiated Rate |
$56.79 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Commercial |
$76.10
|
| Rate for Payer: Aetna Medicare |
$56.79
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: BCBS MAPPO |
$56.79
|
| Rate for Payer: BCN Medicare Advantage |
$56.79
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$81.78
|
| Rate for Payer: Cofinity Commercial |
$76.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.79
|
| Rate for Payer: Healthscope Commercial |
$68.15
|
| Rate for Payer: Healthscope Whirlpool |
$68.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.63
|
| Rate for Payer: Nomi Health Commercial |
$68.15
|
| Rate for Payer: PACE SWMI |
$56.79
|
| Rate for Payer: PHP Medicare Advantage |
$56.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: Priority Health Medicare |
$56.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.79
|
| Rate for Payer: UHC Medicare Advantage |
$56.79
|
| Rate for Payer: UHCCP DNSP |
$56.79
|
|
|
PR SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL
|
Professional
|
Both
|
$782.00
|
|
|
Service Code
|
HCPCS 42340
|
| Min. Negotiated Rate |
$312.80 |
| Max. Negotiated Rate |
$508.30 |
| Rate for Payer: Aetna Commercial |
$440.03
|
| Rate for Payer: Aetna Medicare |
$328.38
|
| Rate for Payer: BCBS Complete |
$312.80
|
| Rate for Payer: BCBS MAPPO |
$328.38
|
| Rate for Payer: BCN Medicare Advantage |
$328.38
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cash Price |
$625.60
|
| Rate for Payer: Cofinity Commercial |
$472.87
|
| Rate for Payer: Cofinity Commercial |
$440.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.38
|
| Rate for Payer: Healthscope Commercial |
$394.06
|
| Rate for Payer: Healthscope Whirlpool |
$394.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.80
|
| Rate for Payer: Nomi Health Commercial |
$394.06
|
| Rate for Payer: PACE SWMI |
$328.38
|
| Rate for Payer: PHP Medicare Advantage |
$328.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.30
|
| Rate for Payer: Priority Health Medicare |
$328.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.38
|
| Rate for Payer: UHC Medicare Advantage |
$328.38
|
| Rate for Payer: UHCCP DNSP |
$328.38
|
|
|
PR SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL
|
Professional
|
Both
|
$1,021.00
|
|
|
Service Code
|
HCPCS 42335
|
| Min. Negotiated Rate |
$251.27 |
| Max. Negotiated Rate |
$663.65 |
| Rate for Payer: Aetna Commercial |
$336.70
|
| Rate for Payer: Aetna Medicare |
$251.27
|
| Rate for Payer: BCBS Complete |
$408.40
|
| Rate for Payer: BCBS MAPPO |
$251.27
|
| Rate for Payer: BCN Medicare Advantage |
$251.27
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cash Price |
$816.80
|
| Rate for Payer: Cofinity Commercial |
$361.83
|
| Rate for Payer: Cofinity Commercial |
$336.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.27
|
| Rate for Payer: Healthscope Commercial |
$301.52
|
| Rate for Payer: Healthscope Whirlpool |
$301.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.83
|
| Rate for Payer: Nomi Health Commercial |
$301.52
|
| Rate for Payer: PACE SWMI |
$251.27
|
| Rate for Payer: PHP Medicare Advantage |
$251.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.65
|
| Rate for Payer: Priority Health Medicare |
$251.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$251.27
|
| Rate for Payer: UHC Medicare Advantage |
$251.27
|
| Rate for Payer: UHCCP DNSP |
$251.27
|
|
|
PR SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL
|
Professional
|
Both
|
$419.00
|
|
|
Service Code
|
HCPCS 42330
|
| Min. Negotiated Rate |
$156.98 |
| Max. Negotiated Rate |
$272.35 |
| Rate for Payer: Aetna Commercial |
$210.35
|
| Rate for Payer: Aetna Medicare |
$156.98
|
| Rate for Payer: BCBS Complete |
$167.60
|
| Rate for Payer: BCBS MAPPO |
$156.98
|
| Rate for Payer: BCN Medicare Advantage |
$156.98
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cash Price |
$335.20
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Cofinity Commercial |
$210.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.98
|
| Rate for Payer: Healthscope Commercial |
$188.38
|
| Rate for Payer: Healthscope Whirlpool |
$188.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.83
|
| Rate for Payer: Nomi Health Commercial |
$188.38
|
| Rate for Payer: PACE SWMI |
$156.98
|
| Rate for Payer: PHP Medicare Advantage |
$156.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.35
|
| Rate for Payer: Priority Health Medicare |
$156.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.98
|
| Rate for Payer: UHC Medicare Advantage |
$156.98
|
| Rate for Payer: UHCCP DNSP |
$156.98
|
|
|
PR SIGMOIDOSCOPY,ABLATE LESN
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 45339
|
| Min. Negotiated Rate |
$300.40 |
| Max. Negotiated Rate |
$488.15 |
| Rate for Payer: Aetna Medicare |
$375.50
|
| Rate for Payer: BCBS Complete |
$300.40
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$488.15
|
|
|
PR SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 45346
|
| Min. Negotiated Rate |
$151.03 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Aetna Commercial |
$202.38
|
| Rate for Payer: Aetna Medicare |
$151.03
|
| Rate for Payer: BCBS Complete |
$302.40
|
| Rate for Payer: BCBS MAPPO |
$151.03
|
| Rate for Payer: BCN Medicare Advantage |
$151.03
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$217.48
|
| Rate for Payer: Cofinity Commercial |
$202.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.03
|
| Rate for Payer: Healthscope Commercial |
$181.24
|
| Rate for Payer: Healthscope Whirlpool |
$181.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.58
|
| Rate for Payer: Nomi Health Commercial |
$181.24
|
| Rate for Payer: PACE SWMI |
$151.03
|
| Rate for Payer: PHP Medicare Advantage |
$151.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health Medicare |
$151.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.03
|
| Rate for Payer: UHC Medicare Advantage |
$151.03
|
| Rate for Payer: UHCCP DNSP |
$151.03
|
|
|
PR SIGMOIDOSCOPY FLX CONTROL BLEEDING
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 45334
|
| Min. Negotiated Rate |
$110.63 |
| Max. Negotiated Rate |
$433.55 |
| Rate for Payer: Aetna Commercial |
$148.24
|
| Rate for Payer: Aetna Medicare |
$110.63
|
| Rate for Payer: BCBS Complete |
$266.80
|
| Rate for Payer: BCBS MAPPO |
$110.63
|
| Rate for Payer: BCN Medicare Advantage |
$110.63
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Cofinity Commercial |
$148.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.63
|
| Rate for Payer: Healthscope Commercial |
$132.76
|
| Rate for Payer: Healthscope Whirlpool |
$132.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.16
|
| Rate for Payer: Nomi Health Commercial |
$132.76
|
| Rate for Payer: PACE SWMI |
$110.63
|
| Rate for Payer: PHP Medicare Advantage |
$110.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.55
|
| Rate for Payer: Priority Health Medicare |
$110.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.63
|
| Rate for Payer: UHC Medicare Advantage |
$110.63
|
| Rate for Payer: UHCCP DNSP |
$110.63
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$161.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$53.91
|
| Rate for Payer: BCBS Complete |
$99.60
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Healthscope Commercial |
$64.69
|
| Rate for Payer: Healthscope Whirlpool |
$64.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
| Rate for Payer: UHCCP DNSP |
$53.91
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$161.85 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$224.10
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$241.53
|
| Rate for Payer: ASR Commercial |
$241.53
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$203.91
|
| Rate for Payer: BCN Commercial |
$193.05
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$234.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$249.00
|
| Rate for Payer: Healthscope Whirlpool |
$241.53
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$224.10
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: Nomi Health Commercial |
$204.18
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.17
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$174.55
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
45330
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$161.85 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$224.10
|
| Rate for Payer: ASR ASR |
$241.53
|
| Rate for Payer: ASR Commercial |
$241.53
|
| Rate for Payer: BCBS Trust/PPO |
$202.91
|
| Rate for Payer: BCN Commercial |
$193.05
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$234.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.20
|
| Rate for Payer: Healthscope Commercial |
$249.00
|
| Rate for Payer: Healthscope Whirlpool |
$241.53
|
| Rate for Payer: Mclaren Commercial |
$224.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.65
|
| Rate for Payer: Nomi Health Commercial |
$204.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.12
|
|
|
PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 45330
|
| Hospital Charge Code |
45330
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$161.85 |
| Rate for Payer: Aetna Commercial |
$72.24
|
| Rate for Payer: Aetna Medicare |
$53.91
|
| Rate for Payer: BCBS Complete |
$99.60
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$77.63
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Healthscope Commercial |
$64.69
|
| Rate for Payer: Healthscope Whirlpool |
$64.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Nomi Health Commercial |
$64.69
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
| Rate for Payer: UHCCP DNSP |
$53.91
|
|
|
PR SIGMOIDOSCOPY FLX NDSC US XM
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 45341
|
| Min. Negotiated Rate |
$116.66 |
| Max. Negotiated Rate |
$193.05 |
| Rate for Payer: Aetna Commercial |
$156.32
|
| Rate for Payer: Aetna Medicare |
$116.66
|
| Rate for Payer: BCBS Complete |
$118.80
|
| Rate for Payer: BCBS MAPPO |
$116.66
|
| Rate for Payer: BCN Medicare Advantage |
$116.66
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Cofinity Commercial |
$156.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.66
|
| Rate for Payer: Healthscope Commercial |
$139.99
|
| Rate for Payer: Healthscope Whirlpool |
$139.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.49
|
| Rate for Payer: Nomi Health Commercial |
$139.99
|
| Rate for Payer: PACE SWMI |
$116.66
|
| Rate for Payer: PHP Medicare Advantage |
$116.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.05
|
| Rate for Payer: Priority Health Medicare |
$116.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.66
|
| Rate for Payer: UHC Medicare Advantage |
$116.66
|
| Rate for Payer: UHCCP DNSP |
$116.66
|
|
|
PR SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 45347
|
| Min. Negotiated Rate |
$145.00 |
| Max. Negotiated Rate |
$241.15 |
| Rate for Payer: Aetna Commercial |
$194.30
|
| Rate for Payer: Aetna Medicare |
$145.00
|
| Rate for Payer: BCBS Complete |
$148.40
|
| Rate for Payer: BCBS MAPPO |
$145.00
|
| Rate for Payer: BCN Medicare Advantage |
$145.00
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$194.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.00
|
| Rate for Payer: Healthscope Commercial |
$174.00
|
| Rate for Payer: Healthscope Whirlpool |
$174.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.25
|
| Rate for Payer: Nomi Health Commercial |
$174.00
|
| Rate for Payer: PACE SWMI |
$145.00
|
| Rate for Payer: PHP Medicare Advantage |
$145.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health Medicare |
$145.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.00
|
| Rate for Payer: UHC Medicare Advantage |
$145.00
|
| Rate for Payer: UHCCP DNSP |
$145.00
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC BALO DILAT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 45340
|
| Min. Negotiated Rate |
$73.32 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: Aetna Medicare |
$73.32
|
| Rate for Payer: BCBS Complete |
$128.80
|
| Rate for Payer: BCBS MAPPO |
$73.32
|
| Rate for Payer: BCN Medicare Advantage |
$73.32
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.32
|
| Rate for Payer: Healthscope Commercial |
$87.98
|
| Rate for Payer: Healthscope Whirlpool |
$87.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.99
|
| Rate for Payer: Nomi Health Commercial |
$87.98
|
| Rate for Payer: PACE SWMI |
$73.32
|
| Rate for Payer: PHP Medicare Advantage |
$73.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Medicare |
$73.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.32
|
| Rate for Payer: UHC Medicare Advantage |
$73.32
|
| Rate for Payer: UHCCP DNSP |
$73.32
|
|
|
PR SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX
|
Professional
|
Both
|
$807.00
|
|
|
Service Code
|
HCPCS 45342
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$524.55 |
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna Medicare |
$160.40
|
| Rate for Payer: BCBS Complete |
$322.80
|
| Rate for Payer: BCBS MAPPO |
$160.40
|
| Rate for Payer: BCN Medicare Advantage |
$160.40
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cash Price |
$645.60
|
| Rate for Payer: Cofinity Commercial |
$230.98
|
| Rate for Payer: Cofinity Commercial |
$214.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.40
|
| Rate for Payer: Healthscope Commercial |
$192.48
|
| Rate for Payer: Healthscope Whirlpool |
$192.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.42
|
| Rate for Payer: Nomi Health Commercial |
$192.48
|
| Rate for Payer: PACE SWMI |
$160.40
|
| Rate for Payer: PHP Medicare Advantage |
$160.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$524.55
|
| Rate for Payer: Priority Health Medicare |
$160.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.40
|
| Rate for Payer: UHC Medicare Advantage |
$160.40
|
| Rate for Payer: UHCCP DNSP |
$160.40
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$222.95 |
| Max. Negotiated Rate |
$343.00 |
| Rate for Payer: Aetna Commercial |
$308.70
|
| Rate for Payer: ASR ASR |
$332.71
|
| Rate for Payer: ASR Commercial |
$332.71
|
| Rate for Payer: BCBS Trust/PPO |
$279.51
|
| Rate for Payer: BCN Commercial |
$265.93
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$322.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Healthscope Commercial |
$343.00
|
| Rate for Payer: Healthscope Whirlpool |
$332.71
|
| Rate for Payer: Mclaren Commercial |
$308.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$281.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$301.84
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Hospital Charge Code |
45331
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$222.95 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$68.58
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$82.30
|
| Rate for Payer: Healthscope Whirlpool |
$82.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
| Rate for Payer: UHCCP DNSP |
$68.58
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$343.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
45331
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$222.95 |
| Max. Negotiated Rate |
$1,378.21 |
| Rate for Payer: Aetna Commercial |
$308.70
|
| Rate for Payer: Aetna Medicare |
$889.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: ASR ASR |
$332.71
|
| Rate for Payer: ASR Commercial |
$332.71
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCBS Trust/PPO |
$280.88
|
| Rate for Payer: BCN Commercial |
$265.93
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$322.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$343.00
|
| Rate for Payer: Healthscope Whirlpool |
$332.71
|
| Rate for Payer: Humana Choice PPO Medicare |
$889.17
|
| Rate for Payer: Mclaren Commercial |
$308.70
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.55
|
| Rate for Payer: Nomi Health Commercial |
$281.26
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$978.09
|
| Rate for Payer: PHP Medicaid |
$476.60
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.54
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health Narrow Network |
$240.44
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$301.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,378.21
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP DNSP |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: VA VA |
$889.17
|
|
|
PR SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 45331
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$222.95 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$68.58
|
| Rate for Payer: BCBS Complete |
$137.20
|
| Rate for Payer: BCBS MAPPO |
$68.58
|
| Rate for Payer: BCN Medicare Advantage |
$68.58
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Cofinity Commercial |
$91.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.58
|
| Rate for Payer: Healthscope Commercial |
$82.30
|
| Rate for Payer: Healthscope Whirlpool |
$82.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.01
|
| Rate for Payer: Nomi Health Commercial |
$82.30
|
| Rate for Payer: PACE SWMI |
$68.58
|
| Rate for Payer: PHP Medicare Advantage |
$68.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.95
|
| Rate for Payer: Priority Health Medicare |
$68.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
| Rate for Payer: UHCCP DNSP |
$68.58
|
|
|
PR SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 45350
|
| Min. Negotiated Rate |
$95.10 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$127.43
|
| Rate for Payer: Aetna Medicare |
$95.10
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$95.10
|
| Rate for Payer: BCN Medicare Advantage |
$95.10
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cofinity Commercial |
$136.94
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.10
|
| Rate for Payer: Healthscope Commercial |
$114.12
|
| Rate for Payer: Healthscope Whirlpool |
$114.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.86
|
| Rate for Payer: Nomi Health Commercial |
$114.12
|
| Rate for Payer: PACE SWMI |
$95.10
|
| Rate for Payer: PHP Medicare Advantage |
$95.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$95.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.10
|
| Rate for Payer: UHC Medicare Advantage |
$95.10
|
| Rate for Payer: UHCCP DNSP |
$95.10
|
|
