|
PR EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER
|
Professional
|
Both
|
$1,019.00
|
|
|
Service Code
|
HCPCS 43233
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$713.30 |
| Rate for Payer: Aetna Commercial |
$298.44
|
| Rate for Payer: Aetna Medicare |
$231.63
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$222.72
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$327.90
|
| Rate for Payer: BCN Medicare Advantage |
$222.72
|
| Rate for Payer: Cash Price |
$815.20
|
| Rate for Payer: Cash Price |
$815.20
|
| Rate for Payer: Cofinity Commercial |
$298.44
|
| Rate for Payer: Cofinity Commercial |
$320.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.72
|
| Rate for Payer: Mclaren Medicaid |
$144.20
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.86
|
| Rate for Payer: PACE SWMI |
$222.72
|
| Rate for Payer: PHP Medicare Advantage |
$222.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$713.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.52
|
| Rate for Payer: Priority Health Medicare |
$222.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$394.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.72
|
| Rate for Payer: UHC Medicare Advantage |
$229.40
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$967.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
43247
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$229.66 |
| Max. Negotiated Rate |
$870.30 |
| Rate for Payer: Aetna Commercial |
$821.95
|
| Rate for Payer: Aetna Medicare |
$251.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.19
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$241.75
|
| Rate for Payer: BCBS Trust/PPO |
$751.84
|
| Rate for Payer: BCN Commercial |
$751.84
|
| Rate for Payer: BCN Medicare Advantage |
$241.75
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$831.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.75
|
| Rate for Payer: Healthscope Commercial |
$870.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.25
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$821.95
|
| Rate for Payer: PACE Senior Care Partners |
$229.66
|
| Rate for Payer: PACE SWMI |
$241.75
|
| Rate for Payer: PHP Commercial |
$821.95
|
| Rate for Payer: PHP Medicare Advantage |
$241.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$841.29
|
| Rate for Payer: Priority Health Medicare |
$241.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$589.77
|
| Rate for Payer: Railroad Medicare Medicare |
$241.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.96
|
| Rate for Payer: UHC Core |
$807.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.75
|
| Rate for Payer: UHC Medicare Advantage |
$249.00
|
| Rate for Payer: VA VA |
$241.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.25
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
HCPCS 43247
|
| Min. Negotiated Rate |
$108.30 |
| Max. Negotiated Rate |
$676.90 |
| Rate for Payer: Aetna Commercial |
$230.27
|
| Rate for Payer: Aetna Medicare |
$178.71
|
| Rate for Payer: BCBS Complete |
$116.75
|
| Rate for Payer: BCBS MAPPO |
$171.84
|
| Rate for Payer: BCBS Trust/PPO |
$108.30
|
| Rate for Payer: BCN Commercial |
$563.45
|
| Rate for Payer: BCN Medicare Advantage |
$171.84
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$230.27
|
| Rate for Payer: Cofinity Commercial |
$247.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.84
|
| Rate for Payer: Mclaren Medicaid |
$111.19
|
| Rate for Payer: Meridian Medicaid |
$116.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$180.43
|
| Rate for Payer: PACE SWMI |
$171.84
|
| Rate for Payer: PHP Medicare Advantage |
$171.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.15
|
| Rate for Payer: Priority Health Medicare |
$171.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.84
|
| Rate for Payer: UHC Medicare Advantage |
$177.00
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$967.00
|
|
|
Service Code
|
CPT 43247
|
| Hospital Charge Code |
43247
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$589.77 |
| Max. Negotiated Rate |
$870.30 |
| Rate for Payer: Aetna Commercial |
$821.95
|
| Rate for Payer: BCBS Trust/PPO |
$747.30
|
| Rate for Payer: BCN Commercial |
$747.30
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$831.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.60
|
| Rate for Payer: Healthscope Commercial |
$870.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$821.95
|
| Rate for Payer: PHP Commercial |
$821.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$841.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$589.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.96
|
| Rate for Payer: UHC Core |
$807.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.25
|
|
|
PR EGD FLEXIBLE FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
HCPCS 43247
|
| Hospital Charge Code |
43247
|
| Min. Negotiated Rate |
$108.30 |
| Max. Negotiated Rate |
$676.90 |
| Rate for Payer: Aetna Commercial |
$230.27
|
| Rate for Payer: Aetna Medicare |
$178.71
|
| Rate for Payer: BCBS Complete |
$116.75
|
| Rate for Payer: BCBS MAPPO |
$171.84
|
| Rate for Payer: BCBS Trust/PPO |
$108.30
|
| Rate for Payer: BCN Commercial |
$563.45
|
| Rate for Payer: BCN Medicare Advantage |
$171.84
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$230.27
|
| Rate for Payer: Cofinity Commercial |
$247.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.84
|
| Rate for Payer: Mclaren Medicaid |
$111.19
|
| Rate for Payer: Meridian Medicaid |
$116.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$180.43
|
| Rate for Payer: PACE SWMI |
$171.84
|
| Rate for Payer: PHP Medicare Advantage |
$171.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.15
|
| Rate for Payer: Priority Health Medicare |
$171.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.84
|
| Rate for Payer: UHC Medicare Advantage |
$177.00
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43250
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$940.37 |
| Rate for Payer: Aetna Commercial |
$222.06
|
| Rate for Payer: Aetna Medicare |
$172.35
|
| Rate for Payer: BCBS Complete |
$112.50
|
| Rate for Payer: BCBS MAPPO |
$165.72
|
| Rate for Payer: BCBS Trust/PPO |
$940.37
|
| Rate for Payer: BCN Commercial |
$664.11
|
| Rate for Payer: BCN Medicare Advantage |
$165.72
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$238.64
|
| Rate for Payer: Cofinity Commercial |
$222.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.72
|
| Rate for Payer: Mclaren Medicaid |
$107.14
|
| Rate for Payer: Meridian Medicaid |
$112.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.01
|
| Rate for Payer: PACE SWMI |
$165.72
|
| Rate for Payer: PHP Medicare Advantage |
$165.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$293.99
|
| Rate for Payer: Priority Health Medicare |
$165.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.72
|
| Rate for Payer: UHC Medicare Advantage |
$170.69
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$1,082.00
|
|
|
Service Code
|
CPT 43250
|
| Hospital Charge Code |
43250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$256.98 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna Commercial |
$919.70
|
| Rate for Payer: Aetna Medicare |
$281.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$338.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$338.12
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$270.50
|
| Rate for Payer: BCBS Trust/PPO |
$841.26
|
| Rate for Payer: BCN Commercial |
$841.26
|
| Rate for Payer: BCN Medicare Advantage |
$270.50
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$930.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$270.50
|
| Rate for Payer: Healthscope Commercial |
$973.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.50
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$284.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$311.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.70
|
| Rate for Payer: PACE Senior Care Partners |
$256.98
|
| Rate for Payer: PACE SWMI |
$270.50
|
| Rate for Payer: PHP Commercial |
$919.70
|
| Rate for Payer: PHP Medicare Advantage |
$270.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$941.34
|
| Rate for Payer: Priority Health Medicare |
$270.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.91
|
| Rate for Payer: Railroad Medicare Medicare |
$270.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$952.16
|
| Rate for Payer: UHC Core |
$903.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$270.50
|
| Rate for Payer: UHC Medicare Advantage |
$278.62
|
| Rate for Payer: VA VA |
$270.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.50
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
IP
|
$1,082.00
|
|
|
Service Code
|
CPT 43250
|
| Hospital Charge Code |
43250
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$659.91 |
| Max. Negotiated Rate |
$973.80 |
| Rate for Payer: Aetna Commercial |
$919.70
|
| Rate for Payer: BCBS Trust/PPO |
$836.17
|
| Rate for Payer: BCN Commercial |
$836.17
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$930.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.60
|
| Rate for Payer: Healthscope Commercial |
$973.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.70
|
| Rate for Payer: PHP Commercial |
$919.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$941.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$952.16
|
| Rate for Payer: UHC Core |
$903.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.50
|
|
|
PR EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43250
|
| Hospital Charge Code |
43250
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$940.37 |
| Rate for Payer: Aetna Commercial |
$222.06
|
| Rate for Payer: Aetna Medicare |
$172.35
|
| Rate for Payer: BCBS Complete |
$112.50
|
| Rate for Payer: BCBS MAPPO |
$165.72
|
| Rate for Payer: BCBS Trust/PPO |
$940.37
|
| Rate for Payer: BCN Commercial |
$664.11
|
| Rate for Payer: BCN Medicare Advantage |
$165.72
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$222.06
|
| Rate for Payer: Cofinity Commercial |
$238.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.72
|
| Rate for Payer: Mclaren Medicaid |
$107.14
|
| Rate for Payer: Meridian Medicaid |
$112.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.01
|
| Rate for Payer: PACE SWMI |
$165.72
|
| Rate for Payer: PHP Medicare Advantage |
$165.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$293.99
|
| Rate for Payer: Priority Health Medicare |
$165.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.72
|
| Rate for Payer: UHC Medicare Advantage |
$170.69
|
|
|
PR EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 43243
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$826.00 |
| Rate for Payer: Aetna Commercial |
$309.22
|
| Rate for Payer: Aetna Medicare |
$239.99
|
| Rate for Payer: BCBS Complete |
$156.78
|
| Rate for Payer: BCBS MAPPO |
$230.76
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: BCN Medicare Advantage |
$230.76
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$332.29
|
| Rate for Payer: Cofinity Commercial |
$309.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.76
|
| Rate for Payer: Mclaren Medicaid |
$149.31
|
| Rate for Payer: Meridian Medicaid |
$156.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$242.30
|
| Rate for Payer: PACE SWMI |
$230.76
|
| Rate for Payer: PHP Medicare Advantage |
$230.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.22
|
| Rate for Payer: Priority Health Medicare |
$230.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.76
|
| Rate for Payer: UHC Medicare Advantage |
$237.68
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
IP
|
$867.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$528.78 |
| Max. Negotiated Rate |
$780.30 |
| Rate for Payer: Aetna Commercial |
$736.95
|
| Rate for Payer: BCBS Trust/PPO |
$670.02
|
| Rate for Payer: BCN Commercial |
$670.02
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$745.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.60
|
| Rate for Payer: Healthscope Commercial |
$780.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.95
|
| Rate for Payer: PHP Commercial |
$736.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.96
|
| Rate for Payer: UHC Core |
$723.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.25
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
OP
|
$867.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$205.91 |
| Max. Negotiated Rate |
$780.30 |
| Rate for Payer: Aetna Commercial |
$736.95
|
| Rate for Payer: Aetna Medicare |
$225.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.94
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$674.09
|
| Rate for Payer: BCN Commercial |
$674.09
|
| Rate for Payer: BCN Medicare Advantage |
$216.75
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$745.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.75
|
| Rate for Payer: Healthscope Commercial |
$780.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.25
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.95
|
| Rate for Payer: PACE Senior Care Partners |
$205.91
|
| Rate for Payer: PACE SWMI |
$216.75
|
| Rate for Payer: PHP Commercial |
$736.95
|
| Rate for Payer: PHP Medicare Advantage |
$216.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.29
|
| Rate for Payer: Priority Health Medicare |
$216.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.78
|
| Rate for Payer: Railroad Medicare Medicare |
$216.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.96
|
| Rate for Payer: UHC Core |
$723.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.75
|
| Rate for Payer: UHC Medicare Advantage |
$223.25
|
| Rate for Payer: VA VA |
$216.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.25
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 43248
|
| Min. Negotiated Rate |
$104.58 |
| Max. Negotiated Rate |
$607.43 |
| Rate for Payer: Aetna Commercial |
$215.85
|
| Rate for Payer: Aetna Medicare |
$167.52
|
| Rate for Payer: BCBS Complete |
$109.81
|
| Rate for Payer: BCBS MAPPO |
$161.08
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$161.08
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$215.85
|
| Rate for Payer: Cofinity Commercial |
$231.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.08
|
| Rate for Payer: Mclaren Medicaid |
$104.58
|
| Rate for Payer: Meridian Medicaid |
$109.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$169.13
|
| Rate for Payer: PACE SWMI |
$161.08
|
| Rate for Payer: PHP Medicare Advantage |
$161.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.34
|
| Rate for Payer: Priority Health Medicare |
$161.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.08
|
| Rate for Payer: UHC Medicare Advantage |
$165.91
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 43248
|
| Hospital Charge Code |
43248
|
| Min. Negotiated Rate |
$104.58 |
| Max. Negotiated Rate |
$607.43 |
| Rate for Payer: Aetna Commercial |
$215.85
|
| Rate for Payer: Aetna Medicare |
$167.52
|
| Rate for Payer: BCBS Complete |
$109.81
|
| Rate for Payer: BCBS MAPPO |
$161.08
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$161.08
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$231.96
|
| Rate for Payer: Cofinity Commercial |
$215.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.08
|
| Rate for Payer: Mclaren Medicaid |
$104.58
|
| Rate for Payer: Meridian Medicaid |
$109.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$169.13
|
| Rate for Payer: PACE SWMI |
$161.08
|
| Rate for Payer: PHP Medicare Advantage |
$161.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.34
|
| Rate for Payer: Priority Health Medicare |
$161.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.08
|
| Rate for Payer: UHC Medicare Advantage |
$165.91
|
|
|
PR EGD INTRALUMINAL TUBE/CATHETER INSERTION
|
Professional
|
Both
|
$856.00
|
|
|
Service Code
|
HCPCS 43241
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$599.20 |
| Rate for Payer: Aetna Commercial |
$184.40
|
| Rate for Payer: Aetna Medicare |
$143.11
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$137.61
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: BCN Medicare Advantage |
$137.61
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$184.40
|
| Rate for Payer: Cofinity Commercial |
$198.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.61
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.49
|
| Rate for Payer: PACE SWMI |
$137.61
|
| Rate for Payer: PHP Medicare Advantage |
$137.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.60
|
| Rate for Payer: Priority Health Medicare |
$137.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.61
|
| Rate for Payer: UHC Medicare Advantage |
$141.74
|
|
|
PR EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY
|
Professional
|
Both
|
$1,013.00
|
|
|
Service Code
|
HCPCS 43242
|
| Min. Negotiated Rate |
$51.77 |
| Max. Negotiated Rate |
$709.10 |
| Rate for Payer: Aetna Commercial |
$342.18
|
| Rate for Payer: Aetna Medicare |
$265.57
|
| Rate for Payer: BCBS Complete |
$173.10
|
| Rate for Payer: BCBS MAPPO |
$255.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.77
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: BCN Medicare Advantage |
$255.36
|
| Rate for Payer: Cash Price |
$810.40
|
| Rate for Payer: Cash Price |
$810.40
|
| Rate for Payer: Cofinity Commercial |
$342.18
|
| Rate for Payer: Cofinity Commercial |
$367.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.36
|
| Rate for Payer: Mclaren Medicaid |
$164.86
|
| Rate for Payer: Meridian Medicaid |
$173.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$268.13
|
| Rate for Payer: PACE SWMI |
$255.36
|
| Rate for Payer: PHP Medicare Advantage |
$255.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.33
|
| Rate for Payer: Priority Health Medicare |
$255.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.36
|
| Rate for Payer: UHC Medicare Advantage |
$263.02
|
|
|
PR EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 43238
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$711.20 |
| Rate for Payer: Aetna Commercial |
$301.63
|
| Rate for Payer: Aetna Medicare |
$234.10
|
| Rate for Payer: BCBS Complete |
$152.97
|
| Rate for Payer: BCBS MAPPO |
$225.10
|
| Rate for Payer: BCBS Trust/PPO |
$14.01
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: BCN Medicare Advantage |
$225.10
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$324.14
|
| Rate for Payer: Cofinity Commercial |
$301.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.10
|
| Rate for Payer: Mclaren Medicaid |
$145.69
|
| Rate for Payer: Meridian Medicaid |
$152.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.36
|
| Rate for Payer: PACE SWMI |
$225.10
|
| Rate for Payer: PHP Medicare Advantage |
$225.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$711.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$399.82
|
| Rate for Payer: Priority Health Medicare |
$225.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.10
|
| Rate for Payer: UHC Medicare Advantage |
$231.85
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 43246
|
| Min. Negotiated Rate |
$69.74 |
| Max. Negotiated Rate |
$992.60 |
| Rate for Payer: Aetna Commercial |
$262.09
|
| Rate for Payer: Aetna Medicare |
$203.41
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$195.59
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$195.59
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$281.65
|
| Rate for Payer: Cofinity Commercial |
$262.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.59
|
| Rate for Payer: Mclaren Medicaid |
$126.10
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.37
|
| Rate for Payer: PACE SWMI |
$195.59
|
| Rate for Payer: PHP Medicare Advantage |
$195.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.32
|
| Rate for Payer: Priority Health Medicare |
$195.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$346.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.59
|
| Rate for Payer: UHC Medicare Advantage |
$201.46
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$864.84 |
| Max. Negotiated Rate |
$1,276.20 |
| Rate for Payer: Aetna Commercial |
$1,205.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.83
|
| Rate for Payer: BCN Commercial |
$1,095.83
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,219.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,134.40
|
| Rate for Payer: Healthscope Commercial |
$1,276.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,063.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,205.30
|
| Rate for Payer: PHP Commercial |
$1,205.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$864.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.84
|
| Rate for Payer: UHC Core |
$1,184.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,063.50
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
OP
|
$1,418.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$336.78 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna Commercial |
$1,205.30
|
| Rate for Payer: Aetna Medicare |
$368.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.12
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$354.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.50
|
| Rate for Payer: BCN Commercial |
$1,102.50
|
| Rate for Payer: BCN Medicare Advantage |
$354.50
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,219.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,134.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.50
|
| Rate for Payer: Healthscope Commercial |
$1,276.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,063.50
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,205.30
|
| Rate for Payer: PACE Senior Care Partners |
$336.78
|
| Rate for Payer: PACE SWMI |
$354.50
|
| Rate for Payer: PHP Commercial |
$1,205.30
|
| Rate for Payer: PHP Medicare Advantage |
$354.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.66
|
| Rate for Payer: Priority Health Medicare |
$354.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$864.84
|
| Rate for Payer: Railroad Medicare Medicare |
$354.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.84
|
| Rate for Payer: UHC Core |
$1,184.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.50
|
| Rate for Payer: UHC Medicare Advantage |
$365.14
|
| Rate for Payer: VA VA |
$354.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,063.50
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,418.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
43246
|
| Min. Negotiated Rate |
$69.74 |
| Max. Negotiated Rate |
$992.60 |
| Rate for Payer: Aetna Commercial |
$262.09
|
| Rate for Payer: Aetna Medicare |
$203.41
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$195.59
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$195.59
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cash Price |
$1,134.40
|
| Rate for Payer: Cofinity Commercial |
$262.09
|
| Rate for Payer: Cofinity Commercial |
$281.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.59
|
| Rate for Payer: Mclaren Medicaid |
$126.10
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.37
|
| Rate for Payer: PACE SWMI |
$195.59
|
| Rate for Payer: PHP Medicare Advantage |
$195.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.32
|
| Rate for Payer: Priority Health Medicare |
$195.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$346.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.59
|
| Rate for Payer: UHC Medicare Advantage |
$201.46
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$277.88 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna Commercial |
$994.50
|
| Rate for Payer: Aetna Medicare |
$304.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$365.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$365.62
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$292.50
|
| Rate for Payer: BCBS Trust/PPO |
$909.68
|
| Rate for Payer: BCN Commercial |
$909.68
|
| Rate for Payer: BCN Medicare Advantage |
$292.50
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$1,006.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.50
|
| Rate for Payer: Healthscope Commercial |
$1,053.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$877.50
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$307.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$336.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$994.50
|
| Rate for Payer: PACE Senior Care Partners |
$277.88
|
| Rate for Payer: PACE SWMI |
$292.50
|
| Rate for Payer: PHP Commercial |
$994.50
|
| Rate for Payer: PHP Medicare Advantage |
$292.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.90
|
| Rate for Payer: Priority Health Medicare |
$292.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.58
|
| Rate for Payer: Railroad Medicare Medicare |
$292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,029.60
|
| Rate for Payer: UHC Core |
$976.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$292.50
|
| Rate for Payer: UHC Medicare Advantage |
$301.28
|
| Rate for Payer: VA VA |
$292.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$877.50
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43251
|
| Min. Negotiated Rate |
$123.11 |
| Max. Negotiated Rate |
$819.00 |
| Rate for Payer: Aetna Commercial |
$255.03
|
| Rate for Payer: Aetna Medicare |
$197.93
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCBS MAPPO |
$190.32
|
| Rate for Payer: BCBS Trust/PPO |
$748.60
|
| Rate for Payer: BCN Commercial |
$729.10
|
| Rate for Payer: BCN Medicare Advantage |
$190.32
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$274.06
|
| Rate for Payer: Cofinity Commercial |
$255.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.32
|
| Rate for Payer: Mclaren Medicaid |
$123.11
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.84
|
| Rate for Payer: PACE SWMI |
$190.32
|
| Rate for Payer: PHP Medicare Advantage |
$190.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.08
|
| Rate for Payer: Priority Health Medicare |
$190.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$338.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.32
|
| Rate for Payer: UHC Medicare Advantage |
$196.03
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43251
|
| Hospital Charge Code |
43251
|
| Min. Negotiated Rate |
$123.11 |
| Max. Negotiated Rate |
$819.00 |
| Rate for Payer: Aetna Commercial |
$255.03
|
| Rate for Payer: Aetna Medicare |
$197.93
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCBS MAPPO |
$190.32
|
| Rate for Payer: BCBS Trust/PPO |
$748.60
|
| Rate for Payer: BCN Commercial |
$729.10
|
| Rate for Payer: BCN Medicare Advantage |
$190.32
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$274.06
|
| Rate for Payer: Cofinity Commercial |
$255.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.32
|
| Rate for Payer: Mclaren Medicaid |
$123.11
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.84
|
| Rate for Payer: PACE SWMI |
$190.32
|
| Rate for Payer: PHP Medicare Advantage |
$190.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.08
|
| Rate for Payer: Priority Health Medicare |
$190.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$338.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.32
|
| Rate for Payer: UHC Medicare Advantage |
$196.03
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$713.58 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$994.50
|
| Rate for Payer: BCBS Trust/PPO |
$904.18
|
| Rate for Payer: BCN Commercial |
$904.18
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$1,006.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.00
|
| Rate for Payer: Healthscope Commercial |
$1,053.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$877.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$994.50
|
| Rate for Payer: PHP Commercial |
$994.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,029.60
|
| Rate for Payer: UHC Core |
$976.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$877.50
|
|
