|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43250
|
| Hospital Charge Code |
43250
|
| Min. Negotiated Rate |
$107.78 |
| Max. Negotiated Rate |
$29,830.00 |
| Rate for Payer: Aetna Commercial |
$216.26
|
| Rate for Payer: Aetna Medicare |
$167.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.40
|
| Rate for Payer: BCBS Complete |
$113.17
|
| Rate for Payer: BCBS MAPPO |
$161.39
|
| Rate for Payer: BCBS Trust/PPO |
$940.37
|
| Rate for Payer: BCN Commercial |
$664.11
|
| Rate for Payer: BCN Medicare Advantage |
$161.39
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$232.40
|
| Rate for Payer: Cofinity Commercial |
$216.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.39
|
| Rate for Payer: Healthscope Commercial |
$298.57
|
| Rate for Payer: Healthscope Commercial |
$258.22
|
| Rate for Payer: Mclaren Medicaid |
$107.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.46
|
| Rate for Payer: Meridian Medicaid |
$113.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,830.00
|
| Rate for Payer: Nomi Health Commercial |
$193.67
|
| Rate for Payer: PACE SWMI |
$161.39
|
| Rate for Payer: PHP Medicare Advantage |
$161.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.09
|
| Rate for Payer: Priority Health Medicare |
$161.39
|
| Rate for Payer: Priority Health Narrow Network |
$300.09
|
| Rate for Payer: Priority Health SBD |
$300.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.39
|
| Rate for Payer: UHC Exchange |
$234.59
|
| Rate for Payer: UHC Medicare Advantage |
$161.39
|
| Rate for Payer: UHCCP Medicaid |
$107.78
|
|
|
PR EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 43243
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$41,537.00 |
| Rate for Payer: Aetna Commercial |
$301.16
|
| Rate for Payer: Aetna Medicare |
$233.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.64
|
| Rate for Payer: BCBS Complete |
$157.45
|
| Rate for Payer: BCBS MAPPO |
$224.75
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: BCN Medicare Advantage |
$224.75
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$323.64
|
| Rate for Payer: Cofinity Commercial |
$301.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.75
|
| Rate for Payer: Healthscope Commercial |
$415.79
|
| Rate for Payer: Healthscope Commercial |
$359.60
|
| Rate for Payer: Mclaren Medicaid |
$149.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.99
|
| Rate for Payer: Meridian Medicaid |
$157.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41,537.00
|
| Rate for Payer: Nomi Health Commercial |
$269.70
|
| Rate for Payer: PACE SWMI |
$224.75
|
| Rate for Payer: PHP Medicare Advantage |
$224.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.22
|
| Rate for Payer: Priority Health Medicare |
$224.75
|
| Rate for Payer: Priority Health Narrow Network |
$418.22
|
| Rate for Payer: Priority Health SBD |
$418.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.75
|
| Rate for Payer: UHC Exchange |
$353.68
|
| Rate for Payer: UHC Medicare Advantage |
$224.75
|
| Rate for Payer: UHCCP Medicaid |
$149.95
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Hospital Charge Code |
43248
|
| Min. Negotiated Rate |
$104.80 |
| Max. Negotiated Rate |
$28,994.00 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$162.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.23
|
| Rate for Payer: BCBS Complete |
$110.04
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Healthscope Commercial |
$289.36
|
| Rate for Payer: Healthscope Commercial |
$250.26
|
| Rate for Payer: Mclaren Medicaid |
$104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Meridian Medicaid |
$110.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,994.00
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.92
|
| Rate for Payer: Priority Health Medicare |
$156.41
|
| Rate for Payer: Priority Health Narrow Network |
$292.92
|
| Rate for Payer: Priority Health SBD |
$292.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Exchange |
$230.55
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
| Rate for Payer: UHCCP Medicaid |
$104.80
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
OP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$173.83 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$751.40
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$394.36
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$760.24
|
| Rate for Payer: Cofinity Commercial |
$618.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$795.60
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$751.40
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$556.92
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.83
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$517.17
|
| Rate for Payer: VA VA |
$918.60
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Min. Negotiated Rate |
$104.80 |
| Max. Negotiated Rate |
$28,994.00 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$162.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.23
|
| Rate for Payer: BCBS Complete |
$110.04
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Healthscope Commercial |
$289.36
|
| Rate for Payer: Healthscope Commercial |
$250.26
|
| Rate for Payer: Mclaren Medicaid |
$104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Meridian Medicaid |
$110.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,994.00
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$292.92
|
| Rate for Payer: Priority Health Medicare |
$156.41
|
| Rate for Payer: Priority Health Narrow Network |
$292.92
|
| Rate for Payer: Priority Health SBD |
$292.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Exchange |
$230.55
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
| Rate for Payer: UHCCP Medicaid |
$104.80
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
IP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$556.92 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: Aetna Commercial |
$751.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.60
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$618.80
|
| Rate for Payer: Cofinity Commercial |
$760.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Healthscope Commercial |
$795.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: PHP Commercial |
$751.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health SBD |
$556.92
|
|
|
PR EGD INTRALUMINAL TUBE/CATHETER INSERTION
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 43241
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$24,770.00 |
| Rate for Payer: Aetna Commercial |
$180.38
|
| Rate for Payer: Aetna Medicare |
$139.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.84
|
| Rate for Payer: BCBS Complete |
$94.60
|
| Rate for Payer: BCBS MAPPO |
$134.61
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: BCN Medicare Advantage |
$134.61
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$193.84
|
| Rate for Payer: Cofinity Commercial |
$180.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.61
|
| Rate for Payer: Healthscope Commercial |
$249.03
|
| Rate for Payer: Healthscope Commercial |
$215.38
|
| Rate for Payer: Mclaren Medicaid |
$90.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.34
|
| Rate for Payer: Meridian Medicaid |
$94.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,770.00
|
| Rate for Payer: Nomi Health Commercial |
$161.53
|
| Rate for Payer: PACE SWMI |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$134.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.17
|
| Rate for Payer: Priority Health Medicare |
$134.61
|
| Rate for Payer: Priority Health Narrow Network |
$251.17
|
| Rate for Payer: Priority Health SBD |
$251.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.61
|
| Rate for Payer: UHC Exchange |
$185.15
|
| Rate for Payer: UHC Medicare Advantage |
$134.61
|
| Rate for Payer: UHCCP Medicaid |
$90.10
|
|
|
PR EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 43242
|
| Min. Negotiated Rate |
$51.77 |
| Max. Negotiated Rate |
$45,965.00 |
| Rate for Payer: Aetna Commercial |
$330.51
|
| Rate for Payer: Aetna Medicare |
$256.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.18
|
| Rate for Payer: BCBS Complete |
$173.33
|
| Rate for Payer: BCBS MAPPO |
$246.65
|
| Rate for Payer: BCBS Trust/PPO |
$51.77
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: BCN Medicare Advantage |
$246.65
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$355.18
|
| Rate for Payer: Cofinity Commercial |
$330.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.65
|
| Rate for Payer: Healthscope Commercial |
$456.30
|
| Rate for Payer: Healthscope Commercial |
$394.64
|
| Rate for Payer: Mclaren Medicaid |
$165.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.98
|
| Rate for Payer: Meridian Medicaid |
$173.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,965.00
|
| Rate for Payer: Nomi Health Commercial |
$295.98
|
| Rate for Payer: PACE SWMI |
$246.65
|
| Rate for Payer: PHP Medicare Advantage |
$246.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.77
|
| Rate for Payer: Priority Health Medicare |
$246.65
|
| Rate for Payer: Priority Health Narrow Network |
$461.77
|
| Rate for Payer: Priority Health SBD |
$461.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.65
|
| Rate for Payer: UHC Exchange |
$428.40
|
| Rate for Payer: UHC Medicare Advantage |
$246.65
|
| Rate for Payer: UHCCP Medicaid |
$165.08
|
|
|
PR EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 43238
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$40,518.00 |
| Rate for Payer: Aetna Commercial |
$293.39
|
| Rate for Payer: Aetna Medicare |
$227.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.29
|
| Rate for Payer: BCBS Complete |
$153.87
|
| Rate for Payer: BCBS MAPPO |
$218.95
|
| Rate for Payer: BCBS Trust/PPO |
$14.01
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: BCN Medicare Advantage |
$218.95
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$315.29
|
| Rate for Payer: Cofinity Commercial |
$293.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.95
|
| Rate for Payer: Healthscope Commercial |
$405.06
|
| Rate for Payer: Healthscope Commercial |
$350.32
|
| Rate for Payer: Mclaren Medicaid |
$146.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.90
|
| Rate for Payer: Meridian Medicaid |
$153.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,518.00
|
| Rate for Payer: Nomi Health Commercial |
$262.74
|
| Rate for Payer: PACE SWMI |
$218.95
|
| Rate for Payer: PHP Medicare Advantage |
$218.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$408.08
|
| Rate for Payer: Priority Health Medicare |
$218.95
|
| Rate for Payer: Priority Health Narrow Network |
$408.08
|
| Rate for Payer: Priority Health SBD |
$408.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.95
|
| Rate for Payer: UHC Exchange |
$304.64
|
| Rate for Payer: UHC Medicare Advantage |
$218.95
|
| Rate for Payer: UHCCP Medicaid |
$146.54
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
43246
|
| Min. Negotiated Rate |
$69.74 |
| Max. Negotiated Rate |
$35,206.00 |
| Rate for Payer: Aetna Commercial |
$254.53
|
| Rate for Payer: Aetna Medicare |
$197.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.53
|
| Rate for Payer: BCBS Complete |
$132.85
|
| Rate for Payer: BCBS MAPPO |
$189.95
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$189.95
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$273.53
|
| Rate for Payer: Cofinity Commercial |
$254.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.95
|
| Rate for Payer: Healthscope Commercial |
$351.41
|
| Rate for Payer: Healthscope Commercial |
$303.92
|
| Rate for Payer: Mclaren Medicaid |
$126.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.45
|
| Rate for Payer: Meridian Medicaid |
$132.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,206.00
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE SWMI |
$189.95
|
| Rate for Payer: PHP Medicare Advantage |
$189.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.18
|
| Rate for Payer: Priority Health Medicare |
$189.95
|
| Rate for Payer: Priority Health Narrow Network |
$353.18
|
| Rate for Payer: Priority Health SBD |
$353.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.95
|
| Rate for Payer: UHC Exchange |
$302.98
|
| Rate for Payer: UHC Medicare Advantage |
$189.95
|
| Rate for Payer: UHCCP Medicaid |
$126.52
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
IP
|
$1,446.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$910.98 |
| Max. Negotiated Rate |
$1,301.40 |
| Rate for Payer: Aetna Commercial |
$1,229.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.90
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,012.20
|
| Rate for Payer: Cofinity Commercial |
$1,243.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,012.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.80
|
| Rate for Payer: Healthscope Commercial |
$1,301.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,229.10
|
| Rate for Payer: PHP Commercial |
$1,229.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health SBD |
$910.98
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 43246
|
| Min. Negotiated Rate |
$69.74 |
| Max. Negotiated Rate |
$35,206.00 |
| Rate for Payer: Aetna Commercial |
$254.53
|
| Rate for Payer: Aetna Medicare |
$197.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$254.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.53
|
| Rate for Payer: BCBS Complete |
$132.85
|
| Rate for Payer: BCBS MAPPO |
$189.95
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$189.95
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$273.53
|
| Rate for Payer: Cofinity Commercial |
$254.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.95
|
| Rate for Payer: Healthscope Commercial |
$351.41
|
| Rate for Payer: Healthscope Commercial |
$303.92
|
| Rate for Payer: Mclaren Medicaid |
$126.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.45
|
| Rate for Payer: Meridian Medicaid |
$132.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,206.00
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE SWMI |
$189.95
|
| Rate for Payer: PHP Medicare Advantage |
$189.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.18
|
| Rate for Payer: Priority Health Medicare |
$189.95
|
| Rate for Payer: Priority Health Narrow Network |
$353.18
|
| Rate for Payer: Priority Health SBD |
$353.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.95
|
| Rate for Payer: UHC Exchange |
$302.98
|
| Rate for Payer: UHC Medicare Advantage |
$189.95
|
| Rate for Payer: UHCCP Medicaid |
$126.52
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
OP
|
$1,446.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$210.86 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna Commercial |
$1,229.10
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$939.90
|
| 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: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$901.23
|
| Rate for Payer: BCN Commercial |
$901.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,243.56
|
| Rate for Payer: Cofinity Commercial |
$1,012.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,012.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,301.40
|
| 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 |
$1,229.10
|
| Rate for Payer: Nomi Health Commercial |
$3,903.12
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$1,229.10
|
| 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 |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,841.66
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$4,673.33
|
| Rate for Payer: Priority Health SBD |
$910.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.86
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$1,046.41
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
IP
|
$1,193.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$751.59 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Aetna Commercial |
$1,014.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.45
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.98
|
| Rate for Payer: Cofinity Commercial |
$835.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$835.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.40
|
| Rate for Payer: Healthscope Commercial |
$1,073.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.05
|
| Rate for Payer: PHP Commercial |
$1,014.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health SBD |
$751.59
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
OP
|
$1,193.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$204.74 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna Commercial |
$1,014.05
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$775.45
|
| 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: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$836.23
|
| Rate for Payer: BCN Commercial |
$836.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$835.10
|
| Rate for Payer: Cofinity Commercial |
$1,025.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$835.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,073.70
|
| 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 |
$1,014.05
|
| Rate for Payer: Nomi Health Commercial |
$3,903.12
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$1,014.05
|
| 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 |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,841.66
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$4,673.33
|
| Rate for Payer: Priority Health SBD |
$751.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.74
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$1,046.41
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 43251
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$34,258.00 |
| Rate for Payer: Aetna Commercial |
$247.30
|
| Rate for Payer: Aetna Medicare |
$191.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.75
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS MAPPO |
$184.55
|
| Rate for Payer: BCBS Trust/PPO |
$748.60
|
| Rate for Payer: BCN Commercial |
$729.10
|
| Rate for Payer: BCN Medicare Advantage |
$184.55
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$265.75
|
| Rate for Payer: Cofinity Commercial |
$247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.55
|
| Rate for Payer: Healthscope Commercial |
$341.42
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Mclaren Medicaid |
$123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.78
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,258.00
|
| Rate for Payer: Nomi Health Commercial |
$221.46
|
| Rate for Payer: PACE SWMI |
$184.55
|
| Rate for Payer: PHP Medicare Advantage |
$184.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.83
|
| Rate for Payer: Priority Health Medicare |
$184.55
|
| Rate for Payer: Priority Health Narrow Network |
$344.83
|
| Rate for Payer: Priority Health SBD |
$344.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.55
|
| Rate for Payer: UHC Exchange |
$269.28
|
| Rate for Payer: UHC Medicare Advantage |
$184.55
|
| Rate for Payer: UHCCP Medicaid |
$123.54
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 43251
|
| Hospital Charge Code |
43251
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$34,258.00 |
| Rate for Payer: Aetna Commercial |
$247.30
|
| Rate for Payer: Aetna Medicare |
$191.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.75
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS MAPPO |
$184.55
|
| Rate for Payer: BCBS Trust/PPO |
$748.60
|
| Rate for Payer: BCN Commercial |
$729.10
|
| Rate for Payer: BCN Medicare Advantage |
$184.55
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$265.75
|
| Rate for Payer: Cofinity Commercial |
$247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.55
|
| Rate for Payer: Healthscope Commercial |
$341.42
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Mclaren Medicaid |
$123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.78
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,258.00
|
| Rate for Payer: Nomi Health Commercial |
$221.46
|
| Rate for Payer: PACE SWMI |
$184.55
|
| Rate for Payer: PHP Medicare Advantage |
$184.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.83
|
| Rate for Payer: Priority Health Medicare |
$184.55
|
| Rate for Payer: Priority Health Narrow Network |
$344.83
|
| Rate for Payer: Priority Health SBD |
$344.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.55
|
| Rate for Payer: UHC Exchange |
$269.28
|
| Rate for Payer: UHC Medicare Advantage |
$184.55
|
| Rate for Payer: UHCCP Medicaid |
$123.54
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$527.94 |
| Max. Negotiated Rate |
$754.20 |
| Rate for Payer: Aetna Commercial |
$712.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.70
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$586.60
|
| Rate for Payer: Cofinity Commercial |
$720.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$586.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.40
|
| Rate for Payer: Healthscope Commercial |
$754.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.30
|
| Rate for Payer: PHP Commercial |
$712.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health SBD |
$527.94
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$145.02 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$712.30
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$482.78
|
| Rate for Payer: BCN Commercial |
$482.78
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$720.68
|
| Rate for Payer: Cofinity Commercial |
$586.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$586.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$754.20
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.30
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$712.30
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$527.94
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.02
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$517.17
|
| Rate for Payer: VA VA |
$918.60
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 43239
|
| Min. Negotiated Rate |
$33.11 |
| Max. Negotiated Rate |
$24,151.00 |
| Rate for Payer: Aetna Commercial |
$174.41
|
| Rate for Payer: Aetna Medicare |
$135.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.43
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$130.16
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$554.16
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Cofinity Commercial |
$174.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| Rate for Payer: Healthscope Commercial |
$240.80
|
| Rate for Payer: Healthscope Commercial |
$208.26
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.67
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,151.00
|
| Rate for Payer: Nomi Health Commercial |
$156.19
|
| Rate for Payer: PACE SWMI |
$130.16
|
| Rate for Payer: PHP Medicare Advantage |
$130.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.61
|
| Rate for Payer: Priority Health Medicare |
$130.16
|
| Rate for Payer: Priority Health Narrow Network |
$244.61
|
| Rate for Payer: Priority Health SBD |
$244.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Exchange |
$365.39
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 43239
|
| Hospital Charge Code |
43239
|
| Min. Negotiated Rate |
$33.11 |
| Max. Negotiated Rate |
$24,151.00 |
| Rate for Payer: Aetna Commercial |
$174.41
|
| Rate for Payer: Aetna Medicare |
$135.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.43
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$130.16
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$554.16
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Cofinity Commercial |
$174.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| Rate for Payer: Healthscope Commercial |
$240.80
|
| Rate for Payer: Healthscope Commercial |
$208.26
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.67
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,151.00
|
| Rate for Payer: Nomi Health Commercial |
$156.19
|
| Rate for Payer: PACE SWMI |
$130.16
|
| Rate for Payer: PHP Medicare Advantage |
$130.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.61
|
| Rate for Payer: Priority Health Medicare |
$130.16
|
| Rate for Payer: Priority Health Narrow Network |
$244.61
|
| Rate for Payer: Priority Health SBD |
$244.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Exchange |
$365.39
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
|
|
PR EGD TRANSORAL CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 43255
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$34,963.00 |
| Rate for Payer: Aetna Commercial |
$252.66
|
| Rate for Payer: Aetna Medicare |
$196.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.51
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$188.55
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$923.11
|
| Rate for Payer: BCN Medicare Advantage |
$188.55
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$271.51
|
| Rate for Payer: Cofinity Commercial |
$252.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.55
|
| Rate for Payer: Healthscope Commercial |
$348.82
|
| Rate for Payer: Healthscope Commercial |
$301.68
|
| Rate for Payer: Mclaren Medicaid |
$126.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.98
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,963.00
|
| Rate for Payer: Nomi Health Commercial |
$226.26
|
| Rate for Payer: PACE SWMI |
$188.55
|
| Rate for Payer: PHP Medicare Advantage |
$188.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$352.00
|
| Rate for Payer: Priority Health Medicare |
$188.55
|
| Rate for Payer: Priority Health Narrow Network |
$352.00
|
| Rate for Payer: Priority Health SBD |
$352.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.55
|
| Rate for Payer: UHC Exchange |
$345.09
|
| Rate for Payer: UHC Medicare Advantage |
$188.55
|
| Rate for Payer: UHCCP Medicaid |
$126.31
|
|
|
PR EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 43254
|
| Min. Negotiated Rate |
$169.97 |
| Max. Negotiated Rate |
$47,162.00 |
| Rate for Payer: Aetna Commercial |
$340.48
|
| Rate for Payer: Aetna Medicare |
$264.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.89
|
| Rate for Payer: BCBS Complete |
$178.47
|
| Rate for Payer: BCBS MAPPO |
$254.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.37
|
| Rate for Payer: BCN Commercial |
$386.55
|
| Rate for Payer: BCN Medicare Advantage |
$254.09
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$365.89
|
| Rate for Payer: Cofinity Commercial |
$340.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.09
|
| Rate for Payer: Healthscope Commercial |
$406.54
|
| Rate for Payer: Healthscope Commercial |
$470.07
|
| Rate for Payer: Mclaren Medicaid |
$169.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.79
|
| Rate for Payer: Meridian Medicaid |
$178.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,162.00
|
| Rate for Payer: Nomi Health Commercial |
$304.91
|
| Rate for Payer: PACE SWMI |
$254.09
|
| Rate for Payer: PHP Medicare Advantage |
$254.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.30
|
| Rate for Payer: Priority Health Medicare |
$254.09
|
| Rate for Payer: Priority Health Narrow Network |
$474.30
|
| Rate for Payer: Priority Health SBD |
$474.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.09
|
| Rate for Payer: UHC Medicare Advantage |
$254.09
|
| Rate for Payer: UHCCP Medicaid |
$169.97
|
|
|
PR EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 43240
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$68,387.00 |
| Rate for Payer: Aetna Commercial |
$492.68
|
| Rate for Payer: Aetna Medicare |
$382.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.44
|
| Rate for Payer: BCBS Complete |
$258.09
|
| Rate for Payer: BCBS MAPPO |
$367.67
|
| Rate for Payer: BCBS Trust/PPO |
$41.74
|
| Rate for Payer: BCN Commercial |
$560.02
|
| Rate for Payer: BCN Medicare Advantage |
$367.67
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$529.44
|
| Rate for Payer: Cofinity Commercial |
$492.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.67
|
| Rate for Payer: Healthscope Commercial |
$680.19
|
| Rate for Payer: Healthscope Commercial |
$588.27
|
| Rate for Payer: Mclaren Medicaid |
$245.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.05
|
| Rate for Payer: Meridian Medicaid |
$258.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68,387.00
|
| Rate for Payer: Nomi Health Commercial |
$441.20
|
| Rate for Payer: PACE SWMI |
$367.67
|
| Rate for Payer: PHP Medicare Advantage |
$367.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$688.47
|
| Rate for Payer: Priority Health Medicare |
$367.67
|
| Rate for Payer: Priority Health Narrow Network |
$688.47
|
| Rate for Payer: Priority Health SBD |
$688.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$367.67
|
| Rate for Payer: UHC Exchange |
$475.23
|
| Rate for Payer: UHC Medicare Advantage |
$367.67
|
| Rate for Payer: UHCCP Medicaid |
$245.80
|
|
|
PR EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 43253
|
| Min. Negotiated Rate |
$165.29 |
| Max. Negotiated Rate |
$45,909.00 |
| Rate for Payer: Aetna Commercial |
$331.02
|
| Rate for Payer: Aetna Medicare |
$256.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.72
|
| Rate for Payer: BCBS Complete |
$173.55
|
| Rate for Payer: BCBS MAPPO |
$247.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCN Commercial |
$376.28
|
| Rate for Payer: BCN Medicare Advantage |
$247.03
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$355.72
|
| Rate for Payer: Cofinity Commercial |
$331.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.03
|
| Rate for Payer: Healthscope Commercial |
$395.25
|
| Rate for Payer: Healthscope Commercial |
$457.01
|
| Rate for Payer: Mclaren Medicaid |
$165.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.38
|
| Rate for Payer: Meridian Medicaid |
$173.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,909.00
|
| Rate for Payer: Nomi Health Commercial |
$296.44
|
| Rate for Payer: PACE SWMI |
$247.03
|
| Rate for Payer: PHP Medicare Advantage |
$247.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.16
|
| Rate for Payer: Priority Health Medicare |
$247.03
|
| Rate for Payer: Priority Health Narrow Network |
$461.16
|
| Rate for Payer: Priority Health SBD |
$461.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.03
|
| Rate for Payer: UHC Medicare Advantage |
$247.03
|
| Rate for Payer: UHCCP Medicaid |
$165.29
|
|
