|
PR ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 43331
|
| Min. Negotiated Rate |
$648.75 |
| Max. Negotiated Rate |
$237,998.00 |
| Rate for Payer: Aetna Commercial |
$1,730.22
|
| Rate for Payer: Aetna Medicare |
$1,342.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.34
|
| Rate for Payer: BCBS Complete |
$893.26
|
| Rate for Payer: BCBS MAPPO |
$1,291.21
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: BCN Commercial |
$1,933.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,291.21
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cofinity Commercial |
$1,859.34
|
| Rate for Payer: Cofinity Commercial |
$1,730.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.21
|
| Rate for Payer: Healthscope Commercial |
$2,388.74
|
| Rate for Payer: Healthscope Commercial |
$2,065.94
|
| Rate for Payer: Mclaren Medicaid |
$850.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,355.77
|
| Rate for Payer: Meridian Medicaid |
$893.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237,998.00
|
| Rate for Payer: Nomi Health Commercial |
$1,549.45
|
| Rate for Payer: PACE SWMI |
$1,291.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,291.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,372.65
|
| Rate for Payer: Priority Health Medicare |
$1,291.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,372.65
|
| Rate for Payer: Priority Health SBD |
$2,372.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,480.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,291.21
|
| Rate for Payer: UHC Exchange |
$1,480.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,291.21
|
| Rate for Payer: UHCCP Medicaid |
$850.72
|
|
|
PR ESOPHAGOSCOPY,ABLATION TUMOR
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 43228
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Medicare |
$720.00
|
| Rate for Payer: BCBS Complete |
$576.00
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$936.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$936.00
|
|
|
PR ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 43214
|
| Min. Negotiated Rate |
$123.97 |
| Max. Negotiated Rate |
$34,189.00 |
| Rate for Payer: Aetna Commercial |
$249.07
|
| Rate for Payer: Aetna Medicare |
$193.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.65
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$185.87
|
| Rate for Payer: BCBS Trust/PPO |
$167.47
|
| Rate for Payer: BCN Commercial |
$280.02
|
| Rate for Payer: BCN Medicare Advantage |
$185.87
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cofinity Commercial |
$267.65
|
| Rate for Payer: Cofinity Commercial |
$249.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.87
|
| Rate for Payer: Healthscope Commercial |
$297.39
|
| Rate for Payer: Healthscope Commercial |
$343.86
|
| Rate for Payer: Mclaren Medicaid |
$123.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.16
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,189.00
|
| Rate for Payer: Nomi Health Commercial |
$223.04
|
| Rate for Payer: PACE SWMI |
$185.87
|
| Rate for Payer: PHP Medicare Advantage |
$185.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$343.04
|
| Rate for Payer: Priority Health Medicare |
$185.87
|
| Rate for Payer: Priority Health Narrow Network |
$343.04
|
| Rate for Payer: Priority Health SBD |
$343.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.87
|
| Rate for Payer: UHC Medicare Advantage |
$185.87
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 43220
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$20,639.00 |
| Rate for Payer: Aetna Commercial |
$150.28
|
| Rate for Payer: Aetna Medicare |
$116.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.50
|
| Rate for Payer: BCBS Complete |
$78.95
|
| Rate for Payer: BCBS MAPPO |
$112.15
|
| Rate for Payer: BCBS Trust/PPO |
$68.34
|
| Rate for Payer: BCN Commercial |
$1,333.11
|
| Rate for Payer: BCN Medicare Advantage |
$112.15
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$161.50
|
| Rate for Payer: Cofinity Commercial |
$150.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.15
|
| Rate for Payer: Healthscope Commercial |
$207.48
|
| Rate for Payer: Healthscope Commercial |
$179.44
|
| Rate for Payer: Mclaren Medicaid |
$75.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.76
|
| Rate for Payer: Meridian Medicaid |
$78.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,639.00
|
| Rate for Payer: Nomi Health Commercial |
$134.58
|
| Rate for Payer: PACE SWMI |
$112.15
|
| Rate for Payer: PHP Medicare Advantage |
$112.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$112.15
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: Priority Health SBD |
$208.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.15
|
| Rate for Payer: UHC Exchange |
$158.48
|
| Rate for Payer: UHC Medicare Advantage |
$112.15
|
| Rate for Payer: UHCCP Medicaid |
$75.19
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43226
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$22,907.00 |
| Rate for Payer: Aetna Commercial |
$167.35
|
| Rate for Payer: Aetna Medicare |
$129.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.84
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$124.89
|
| Rate for Payer: BCBS Trust/PPO |
$127.32
|
| Rate for Payer: BCN Commercial |
$569.31
|
| Rate for Payer: BCN Medicare Advantage |
$124.89
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Cofinity Commercial |
$167.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.89
|
| Rate for Payer: Healthscope Commercial |
$231.05
|
| Rate for Payer: Healthscope Commercial |
$199.82
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.13
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,907.00
|
| Rate for Payer: Nomi Health Commercial |
$149.87
|
| Rate for Payer: PACE SWMI |
$124.89
|
| Rate for Payer: PHP Medicare Advantage |
$124.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$230.88
|
| Rate for Payer: Priority Health Medicare |
$124.89
|
| Rate for Payer: Priority Health Narrow Network |
$230.88
|
| Rate for Payer: Priority Health SBD |
$230.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.89
|
| Rate for Payer: UHC Exchange |
$173.07
|
| Rate for Payer: UHC Medicare Advantage |
$124.89
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$24,757.00 |
| Rate for Payer: Aetna Commercial |
$180.47
|
| Rate for Payer: Aetna Medicare |
$140.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS MAPPO |
$134.68
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: BCN Medicare Advantage |
$134.68
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$193.94
|
| Rate for Payer: Cofinity Commercial |
$180.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.68
|
| Rate for Payer: Healthscope Commercial |
$249.16
|
| Rate for Payer: Healthscope Commercial |
$215.49
|
| Rate for Payer: Mclaren Medicaid |
$89.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.41
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,757.00
|
| Rate for Payer: Nomi Health Commercial |
$161.62
|
| Rate for Payer: PACE SWMI |
$134.68
|
| Rate for Payer: PHP Medicare Advantage |
$134.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Medicare |
$134.68
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: Priority Health SBD |
$249.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.68
|
| Rate for Payer: UHC Exchange |
$191.91
|
| Rate for Payer: UHC Medicare Advantage |
$134.68
|
| Rate for Payer: UHCCP Medicaid |
$89.89
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$1,053.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$148.90 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna Commercial |
$895.05
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.45
|
| 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 |
$498.22
|
| Rate for Payer: BCN Commercial |
$498.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$905.58
|
| Rate for Payer: Cofinity Commercial |
$737.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$947.70
|
| 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 |
$895.05
|
| 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 |
$895.05
|
| 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 |
$684.45
|
| 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 |
$663.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.90
|
| 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 ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
IP
|
$1,053.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$663.39 |
| Max. Negotiated Rate |
$947.70 |
| Rate for Payer: Aetna Commercial |
$895.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.45
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$737.10
|
| Rate for Payer: Cofinity Commercial |
$905.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Healthscope Commercial |
$947.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: PHP Commercial |
$895.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health SBD |
$663.39
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 43215
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$24,757.00 |
| Rate for Payer: Aetna Commercial |
$180.47
|
| Rate for Payer: Aetna Medicare |
$140.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS MAPPO |
$134.68
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: BCN Medicare Advantage |
$134.68
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$193.94
|
| Rate for Payer: Cofinity Commercial |
$180.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.68
|
| Rate for Payer: Healthscope Commercial |
$249.16
|
| Rate for Payer: Healthscope Commercial |
$215.49
|
| Rate for Payer: Mclaren Medicaid |
$89.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.41
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,757.00
|
| Rate for Payer: Nomi Health Commercial |
$161.62
|
| Rate for Payer: PACE SWMI |
$134.68
|
| Rate for Payer: PHP Medicare Advantage |
$134.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Medicare |
$134.68
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: Priority Health SBD |
$249.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.68
|
| Rate for Payer: UHC Exchange |
$191.91
|
| Rate for Payer: UHC Medicare Advantage |
$134.68
|
| Rate for Payer: UHCCP Medicaid |
$89.89
|
|
|
PR ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43217
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$27,839.00 |
| Rate for Payer: Aetna Commercial |
$202.22
|
| Rate for Payer: Aetna Medicare |
$156.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.31
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$150.91
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$150.91
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$217.31
|
| Rate for Payer: Cofinity Commercial |
$202.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.91
|
| Rate for Payer: Healthscope Commercial |
$279.18
|
| Rate for Payer: Healthscope Commercial |
$241.46
|
| Rate for Payer: Mclaren Medicaid |
$101.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.46
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,839.00
|
| Rate for Payer: Nomi Health Commercial |
$181.09
|
| Rate for Payer: PACE SWMI |
$150.91
|
| Rate for Payer: PHP Medicare Advantage |
$150.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.19
|
| Rate for Payer: Priority Health Medicare |
$150.91
|
| Rate for Payer: Priority Health Narrow Network |
$282.19
|
| Rate for Payer: Priority Health SBD |
$282.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.91
|
| Rate for Payer: UHC Exchange |
$391.82
|
| Rate for Payer: UHC Medicare Advantage |
$150.91
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 43200
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$15,385.00 |
| Rate for Payer: Aetna Commercial |
$111.31
|
| Rate for Payer: Aetna Medicare |
$86.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.62
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$83.07
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$388.99
|
| Rate for Payer: BCN Medicare Advantage |
$83.07
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Cofinity Commercial |
$111.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.07
|
| Rate for Payer: Healthscope Commercial |
$153.68
|
| Rate for Payer: Healthscope Commercial |
$132.91
|
| Rate for Payer: Mclaren Medicaid |
$55.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.22
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,385.00
|
| Rate for Payer: Nomi Health Commercial |
$99.68
|
| Rate for Payer: PACE SWMI |
$83.07
|
| Rate for Payer: PHP Medicare Advantage |
$83.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.30
|
| Rate for Payer: Priority Health Medicare |
$83.07
|
| Rate for Payer: Priority Health Narrow Network |
$156.30
|
| Rate for Payer: Priority Health SBD |
$156.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.07
|
| Rate for Payer: UHC Exchange |
$360.05
|
| Rate for Payer: UHC Medicare Advantage |
$83.07
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43231
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$27,551.00 |
| Rate for Payer: Aetna Commercial |
$196.12
|
| Rate for Payer: Aetna Medicare |
$152.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.76
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS MAPPO |
$146.36
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$146.36
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$210.76
|
| Rate for Payer: Cofinity Commercial |
$196.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.36
|
| Rate for Payer: Healthscope Commercial |
$270.77
|
| Rate for Payer: Healthscope Commercial |
$234.18
|
| Rate for Payer: Mclaren Medicaid |
$98.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.68
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,551.00
|
| Rate for Payer: Nomi Health Commercial |
$175.63
|
| Rate for Payer: PACE SWMI |
$146.36
|
| Rate for Payer: PHP Medicare Advantage |
$146.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.81
|
| Rate for Payer: Priority Health Medicare |
$146.36
|
| Rate for Payer: Priority Health Narrow Network |
$276.81
|
| Rate for Payer: Priority Health SBD |
$276.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.36
|
| Rate for Payer: UHC Exchange |
$237.54
|
| Rate for Payer: UHC Medicare Advantage |
$146.36
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$108.10 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna Commercial |
$670.65
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.85
|
| 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 |
$543.65
|
| Rate for Payer: BCN Commercial |
$543.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$552.30
|
| Rate for Payer: Cofinity Commercial |
$678.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$710.10
|
| 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 |
$670.65
|
| 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 |
$670.65
|
| 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 |
$512.85
|
| 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 |
$497.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.10
|
| 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 ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$18,002.00 |
| Rate for Payer: Aetna Commercial |
$129.97
|
| Rate for Payer: Aetna Medicare |
$100.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.67
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$96.99
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: BCN Medicare Advantage |
$96.99
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$139.67
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.99
|
| Rate for Payer: Healthscope Commercial |
$179.43
|
| Rate for Payer: Healthscope Commercial |
$155.18
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.84
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,002.00
|
| Rate for Payer: Nomi Health Commercial |
$116.39
|
| Rate for Payer: PACE SWMI |
$96.99
|
| Rate for Payer: PHP Medicare Advantage |
$96.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.56
|
| Rate for Payer: Priority Health Medicare |
$96.99
|
| Rate for Payer: Priority Health Narrow Network |
$182.56
|
| Rate for Payer: Priority Health SBD |
$182.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.99
|
| Rate for Payer: UHC Exchange |
$323.88
|
| Rate for Payer: UHC Medicare Advantage |
$96.99
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$497.07 |
| Max. Negotiated Rate |
$710.10 |
| Rate for Payer: Aetna Commercial |
$670.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.85
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$552.30
|
| Rate for Payer: Cofinity Commercial |
$678.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.20
|
| Rate for Payer: Healthscope Commercial |
$710.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.65
|
| Rate for Payer: PHP Commercial |
$670.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health SBD |
$497.07
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$18,002.00 |
| Rate for Payer: Aetna Commercial |
$129.97
|
| Rate for Payer: Aetna Medicare |
$100.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.67
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$96.99
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: BCN Medicare Advantage |
$96.99
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$139.67
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.99
|
| Rate for Payer: Healthscope Commercial |
$179.43
|
| Rate for Payer: Healthscope Commercial |
$155.18
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.84
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,002.00
|
| Rate for Payer: Nomi Health Commercial |
$116.39
|
| Rate for Payer: PACE SWMI |
$96.99
|
| Rate for Payer: PHP Medicare Advantage |
$96.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.56
|
| Rate for Payer: Priority Health Medicare |
$96.99
|
| Rate for Payer: Priority Health Narrow Network |
$182.56
|
| Rate for Payer: Priority Health SBD |
$182.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.99
|
| Rate for Payer: UHC Exchange |
$323.88
|
| Rate for Payer: UHC Medicare Advantage |
$96.99
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 43201
|
| Min. Negotiated Rate |
$30.11 |
| Max. Negotiated Rate |
$18,133.00 |
| Rate for Payer: Aetna Commercial |
$131.27
|
| Rate for Payer: Aetna Medicare |
$101.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.06
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$97.96
|
| Rate for Payer: BCBS Trust/PPO |
$30.11
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: BCN Medicare Advantage |
$97.96
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$141.06
|
| Rate for Payer: Cofinity Commercial |
$131.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.96
|
| Rate for Payer: Healthscope Commercial |
$181.23
|
| Rate for Payer: Healthscope Commercial |
$156.74
|
| Rate for Payer: Mclaren Medicaid |
$65.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.86
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,133.00
|
| Rate for Payer: Nomi Health Commercial |
$117.55
|
| Rate for Payer: PACE SWMI |
$97.96
|
| Rate for Payer: PHP Medicare Advantage |
$97.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.76
|
| Rate for Payer: Priority Health Medicare |
$97.96
|
| Rate for Payer: Priority Health Narrow Network |
$183.76
|
| Rate for Payer: Priority Health SBD |
$183.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.96
|
| Rate for Payer: UHC Exchange |
$274.28
|
| Rate for Payer: UHC Medicare Advantage |
$97.96
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43227
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$28,827.00 |
| Rate for Payer: Aetna Commercial |
$208.33
|
| Rate for Payer: Aetna Medicare |
$161.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.88
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$155.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.32
|
| Rate for Payer: BCN Commercial |
$876.20
|
| Rate for Payer: BCN Medicare Advantage |
$155.47
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$223.88
|
| Rate for Payer: Cofinity Commercial |
$208.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.47
|
| Rate for Payer: Healthscope Commercial |
$287.62
|
| Rate for Payer: Healthscope Commercial |
$248.75
|
| Rate for Payer: Mclaren Medicaid |
$104.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.24
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,827.00
|
| Rate for Payer: Nomi Health Commercial |
$186.56
|
| Rate for Payer: PACE SWMI |
$155.47
|
| Rate for Payer: PHP Medicare Advantage |
$155.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.13
|
| Rate for Payer: Priority Health Medicare |
$155.47
|
| Rate for Payer: Priority Health Narrow Network |
$291.13
|
| Rate for Payer: Priority Health SBD |
$291.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.47
|
| Rate for Payer: UHC Exchange |
$256.93
|
| Rate for Payer: UHC Medicare Advantage |
$155.47
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43204
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$23,598.00 |
| Rate for Payer: Aetna Commercial |
$170.90
|
| Rate for Payer: Aetna Medicare |
$132.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.66
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$127.54
|
| Rate for Payer: BCBS Trust/PPO |
$249.36
|
| Rate for Payer: BCN Commercial |
$194.01
|
| Rate for Payer: BCN Medicare Advantage |
$127.54
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$183.66
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.54
|
| Rate for Payer: Healthscope Commercial |
$235.95
|
| Rate for Payer: Healthscope Commercial |
$204.06
|
| Rate for Payer: Mclaren Medicaid |
$85.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.92
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,598.00
|
| Rate for Payer: Nomi Health Commercial |
$153.05
|
| Rate for Payer: PACE SWMI |
$127.54
|
| Rate for Payer: PHP Medicare Advantage |
$127.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.05
|
| Rate for Payer: Priority Health Medicare |
$127.54
|
| Rate for Payer: Priority Health Narrow Network |
$238.05
|
| Rate for Payer: Priority Health SBD |
$238.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.54
|
| Rate for Payer: UHC Exchange |
$257.86
|
| Rate for Payer: UHC Medicare Advantage |
$127.54
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 43229
|
| Min. Negotiated Rate |
$123.53 |
| Max. Negotiated Rate |
$34,391.00 |
| Rate for Payer: Aetna Commercial |
$248.28
|
| Rate for Payer: Aetna Medicare |
$192.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.80
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$185.28
|
| Rate for Payer: BCBS Trust/PPO |
$123.53
|
| Rate for Payer: BCN Commercial |
$1,048.21
|
| Rate for Payer: BCN Medicare Advantage |
$185.28
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$266.80
|
| Rate for Payer: Cofinity Commercial |
$248.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.28
|
| Rate for Payer: Healthscope Commercial |
$296.45
|
| Rate for Payer: Healthscope Commercial |
$342.77
|
| Rate for Payer: Mclaren Medicaid |
$123.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.54
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,391.00
|
| Rate for Payer: Nomi Health Commercial |
$222.34
|
| Rate for Payer: PACE SWMI |
$185.28
|
| Rate for Payer: PHP Medicare Advantage |
$185.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.62
|
| Rate for Payer: Priority Health Medicare |
$185.28
|
| Rate for Payer: Priority Health Narrow Network |
$346.62
|
| Rate for Payer: Priority Health SBD |
$346.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.28
|
| Rate for Payer: UHC Medicare Advantage |
$185.28
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR ESOPHAGOSCOPY,INSERT TUBE/STENT
|
Professional
|
Both
|
$1,496.00
|
|
|
Service Code
|
HCPCS 43219
|
| Min. Negotiated Rate |
$598.40 |
| Max. Negotiated Rate |
$972.40 |
| Rate for Payer: Aetna Medicare |
$748.00
|
| Rate for Payer: BCBS Complete |
$598.40
|
| Rate for Payer: Cash Price |
$1,196.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.40
|
|
|
PR ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX
|
Professional
|
Both
|
$1,034.00
|
|
|
Service Code
|
HCPCS 43232
|
| Min. Negotiated Rate |
$81.89 |
| Max. Negotiated Rate |
$34,506.00 |
| Rate for Payer: Aetna Commercial |
$249.67
|
| Rate for Payer: Aetna Medicare |
$193.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.30
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$186.32
|
| Rate for Payer: BCBS Trust/PPO |
$81.89
|
| Rate for Payer: BCN Commercial |
$282.95
|
| Rate for Payer: BCN Medicare Advantage |
$186.32
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cofinity Commercial |
$268.30
|
| Rate for Payer: Cofinity Commercial |
$249.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.32
|
| Rate for Payer: Healthscope Commercial |
$344.69
|
| Rate for Payer: Healthscope Commercial |
$298.11
|
| Rate for Payer: Mclaren Medicaid |
$124.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.64
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,506.00
|
| Rate for Payer: Nomi Health Commercial |
$223.58
|
| Rate for Payer: PACE SWMI |
$186.32
|
| Rate for Payer: PHP Medicare Advantage |
$186.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.20
|
| Rate for Payer: Priority Health Medicare |
$186.32
|
| Rate for Payer: Priority Health Narrow Network |
$350.20
|
| Rate for Payer: Priority Health SBD |
$350.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.32
|
| Rate for Payer: UHC Exchange |
$331.10
|
| Rate for Payer: UHC Medicare Advantage |
$186.32
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 43195
|
| Min. Negotiated Rate |
$29.06 |
| Max. Negotiated Rate |
$32,728.00 |
| Rate for Payer: Aetna Commercial |
$237.92
|
| Rate for Payer: Aetna Medicare |
$184.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.67
|
| Rate for Payer: BCBS Complete |
$125.02
|
| Rate for Payer: BCBS MAPPO |
$177.55
|
| Rate for Payer: BCBS Trust/PPO |
$29.06
|
| Rate for Payer: BCN Commercial |
$269.26
|
| Rate for Payer: BCN Medicare Advantage |
$177.55
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$255.67
|
| Rate for Payer: Cofinity Commercial |
$237.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.55
|
| Rate for Payer: Healthscope Commercial |
$284.08
|
| Rate for Payer: Healthscope Commercial |
$328.47
|
| Rate for Payer: Mclaren Medicaid |
$119.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.43
|
| Rate for Payer: Meridian Medicaid |
$125.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32,728.00
|
| Rate for Payer: Nomi Health Commercial |
$213.06
|
| Rate for Payer: PACE SWMI |
$177.55
|
| Rate for Payer: PHP Medicare Advantage |
$177.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.51
|
| Rate for Payer: Priority Health Medicare |
$177.55
|
| Rate for Payer: Priority Health Narrow Network |
$330.51
|
| Rate for Payer: Priority Health SBD |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.55
|
| Rate for Payer: UHC Medicare Advantage |
$177.55
|
| Rate for Payer: UHCCP Medicaid |
$119.07
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 43191
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$27,452.00 |
| Rate for Payer: Aetna Commercial |
$199.62
|
| Rate for Payer: Aetna Medicare |
$154.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.52
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$148.97
|
| Rate for Payer: BCBS Trust/PPO |
$63.92
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$148.97
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$214.52
|
| Rate for Payer: Cofinity Commercial |
$199.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.97
|
| Rate for Payer: Healthscope Commercial |
$238.35
|
| Rate for Payer: Healthscope Commercial |
$275.59
|
| Rate for Payer: Mclaren Medicaid |
$100.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.42
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,452.00
|
| Rate for Payer: Nomi Health Commercial |
$178.76
|
| Rate for Payer: PACE SWMI |
$148.97
|
| Rate for Payer: PHP Medicare Advantage |
$148.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.01
|
| Rate for Payer: Priority Health Medicare |
$148.97
|
| Rate for Payer: Priority Health Narrow Network |
$278.01
|
| Rate for Payer: Priority Health SBD |
$278.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.97
|
| Rate for Payer: UHC Medicare Advantage |
$148.97
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 43192
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$30,046.00 |
| Rate for Payer: Aetna Commercial |
$217.08
|
| Rate for Payer: Aetna Medicare |
$168.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.28
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS MAPPO |
$162.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$247.27
|
| Rate for Payer: BCN Medicare Advantage |
$162.00
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$233.28
|
| Rate for Payer: Cofinity Commercial |
$217.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.00
|
| Rate for Payer: Healthscope Commercial |
$259.20
|
| Rate for Payer: Healthscope Commercial |
$299.70
|
| Rate for Payer: Mclaren Medicaid |
$108.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.10
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,046.00
|
| Rate for Payer: Nomi Health Commercial |
$194.40
|
| Rate for Payer: PACE SWMI |
$162.00
|
| Rate for Payer: PHP Medicare Advantage |
$162.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.66
|
| Rate for Payer: Priority Health Medicare |
$162.00
|
| Rate for Payer: Priority Health Narrow Network |
$303.66
|
| Rate for Payer: Priority Health SBD |
$303.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.00
|
| Rate for Payer: UHC Medicare Advantage |
$162.00
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
|
