|
PR ERCP,RMV F.B./CHANGE STENT
|
Professional
|
Both
|
$1,660.00
|
|
|
Service Code
|
HCPCS 43269
|
| Min. Negotiated Rate |
$664.00 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: BCBS Complete |
$664.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.00
|
|
|
PR ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT
|
Professional
|
Both
|
$1,401.00
|
|
|
Service Code
|
HCPCS 43274
|
| Min. Negotiated Rate |
$289.89 |
| Max. Negotiated Rate |
$980.70 |
| Rate for Payer: Aetna Commercial |
$601.31
|
| Rate for Payer: Aetna Medicare |
$466.69
|
| Rate for Payer: BCBS Complete |
$304.38
|
| Rate for Payer: BCBS MAPPO |
$448.74
|
| Rate for Payer: BCBS Trust/PPO |
$813.05
|
| Rate for Payer: BCN Commercial |
$661.18
|
| Rate for Payer: BCN Medicare Advantage |
$448.74
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cash Price |
$1,120.80
|
| Rate for Payer: Cofinity Commercial |
$646.19
|
| Rate for Payer: Cofinity Commercial |
$601.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$448.74
|
| Rate for Payer: Mclaren Medicaid |
$289.89
|
| Rate for Payer: Meridian Medicaid |
$304.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$471.18
|
| Rate for Payer: PACE SWMI |
$448.74
|
| Rate for Payer: PHP Medicare Advantage |
$448.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$795.52
|
| Rate for Payer: Priority Health Medicare |
$448.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$795.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$448.74
|
| Rate for Payer: UHC Medicare Advantage |
$462.20
|
|
|
PR ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 43278
|
| Min. Negotiated Rate |
$271.36 |
| Max. Negotiated Rate |
$925.40 |
| Rate for Payer: Aetna Commercial |
$562.13
|
| Rate for Payer: Aetna Medicare |
$436.28
|
| Rate for Payer: BCBS Complete |
$284.93
|
| Rate for Payer: BCBS MAPPO |
$419.50
|
| Rate for Payer: BCBS Trust/PPO |
$722.19
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$419.50
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$604.08
|
| Rate for Payer: Cofinity Commercial |
$562.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.50
|
| Rate for Payer: Mclaren Medicaid |
$271.36
|
| Rate for Payer: Meridian Medicaid |
$284.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.48
|
| Rate for Payer: PACE SWMI |
$419.50
|
| Rate for Payer: PHP Medicare Advantage |
$419.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.78
|
| Rate for Payer: Priority Health Medicare |
$419.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$743.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$419.50
|
| Rate for Payer: UHC Medicare Advantage |
$432.08
|
|
|
PR ERCP W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 43261
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$1,040.08 |
| Rate for Payer: Aetna Commercial |
$440.20
|
| Rate for Payer: Aetna Medicare |
$341.65
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$328.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.08
|
| Rate for Payer: BCN Commercial |
$484.28
|
| Rate for Payer: BCN Medicare Advantage |
$328.51
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$473.05
|
| Rate for Payer: Cofinity Commercial |
$440.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.51
|
| Rate for Payer: Mclaren Medicaid |
$212.36
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.94
|
| Rate for Payer: PACE SWMI |
$328.51
|
| Rate for Payer: PHP Medicare Advantage |
$328.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$582.68
|
| Rate for Payer: Priority Health Medicare |
$328.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$582.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.51
|
| Rate for Payer: UHC Medicare Advantage |
$338.37
|
|
|
PR ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI
|
Professional
|
Both
|
$1,590.00
|
|
|
Service Code
|
HCPCS 43263
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$1,113.00 |
| Rate for Payer: Aetna Commercial |
$464.59
|
| Rate for Payer: Aetna Medicare |
$360.58
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$346.71
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$346.71
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$499.26
|
| Rate for Payer: Cofinity Commercial |
$464.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.71
|
| Rate for Payer: Mclaren Medicaid |
$224.08
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.05
|
| Rate for Payer: PACE SWMI |
$346.71
|
| Rate for Payer: PHP Medicare Advantage |
$346.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.02
|
| Rate for Payer: Priority Health Medicare |
$346.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.71
|
| Rate for Payer: UHC Medicare Advantage |
$357.11
|
|
|
PR ERCP W/SPHINCTEROTOMY/PAPILLOTOMY
|
Professional
|
Both
|
$1,655.00
|
|
|
Service Code
|
HCPCS 43262
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$1,187.83 |
| Rate for Payer: Aetna Commercial |
$464.18
|
| Rate for Payer: Aetna Medicare |
$360.26
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$346.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.83
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$346.40
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cash Price |
$1,324.00
|
| Rate for Payer: Cofinity Commercial |
$464.18
|
| Rate for Payer: Cofinity Commercial |
$498.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.40
|
| Rate for Payer: Mclaren Medicaid |
$223.65
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.72
|
| Rate for Payer: PACE SWMI |
$346.40
|
| Rate for Payer: PHP Medicare Advantage |
$346.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,158.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.43
|
| Rate for Payer: Priority Health Medicare |
$346.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$614.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.40
|
| Rate for Payer: UHC Medicare Advantage |
$356.79
|
|
|
PR ESCHAROTOMY EACH ADDITIONAL INCISION
|
Professional
|
Both
|
$425.00
|
|
|
Service Code
|
HCPCS 16036
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Aetna Commercial |
$109.73
|
| Rate for Payer: Aetna Medicare |
$85.17
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: BCBS MAPPO |
$81.89
|
| Rate for Payer: BCBS Trust/PPO |
$119.96
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$81.89
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cofinity Commercial |
$109.73
|
| Rate for Payer: Cofinity Commercial |
$117.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.89
|
| Rate for Payer: Mclaren Medicaid |
$52.19
|
| Rate for Payer: Meridian Medicaid |
$54.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.98
|
| Rate for Payer: PACE SWMI |
$81.89
|
| Rate for Payer: PHP Medicare Advantage |
$81.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.70
|
| Rate for Payer: Priority Health Medicare |
$81.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.89
|
| Rate for Payer: UHC Medicare Advantage |
$84.35
|
|
|
PR ESCHAROTOMY FIRST INCISION
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 16035
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$590.10 |
| Rate for Payer: Aetna Commercial |
$257.44
|
| Rate for Payer: Aetna Medicare |
$199.80
|
| Rate for Payer: BCBS Complete |
$130.39
|
| Rate for Payer: BCBS MAPPO |
$192.12
|
| Rate for Payer: BCBS Trust/PPO |
$23.70
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: BCN Medicare Advantage |
$192.12
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$276.65
|
| Rate for Payer: Cofinity Commercial |
$257.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.12
|
| Rate for Payer: Mclaren Medicaid |
$124.18
|
| Rate for Payer: Meridian Medicaid |
$130.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.73
|
| Rate for Payer: PACE SWMI |
$192.12
|
| Rate for Payer: PHP Medicare Advantage |
$192.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.76
|
| Rate for Payer: Priority Health Medicare |
$192.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.12
|
| Rate for Payer: UHC Medicare Advantage |
$197.88
|
|
|
PR ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH
|
Professional
|
Both
|
$3,398.00
|
|
|
Service Code
|
HCPCS 43325
|
| Min. Negotiated Rate |
$868.19 |
| Max. Negotiated Rate |
$2,385.99 |
| Rate for Payer: Aetna Commercial |
$1,812.58
|
| Rate for Payer: Aetna Medicare |
$1,406.78
|
| Rate for Payer: BCBS Complete |
$911.60
|
| Rate for Payer: BCBS MAPPO |
$1,352.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,668.90
|
| Rate for Payer: BCN Commercial |
$1,983.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.67
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cash Price |
$2,718.40
|
| Rate for Payer: Cofinity Commercial |
$1,947.84
|
| Rate for Payer: Cofinity Commercial |
$1,812.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.67
|
| Rate for Payer: Mclaren Medicaid |
$868.19
|
| Rate for Payer: Meridian Medicaid |
$911.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,420.30
|
| Rate for Payer: PACE SWMI |
$1,352.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$868.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,378.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,385.99
|
| Rate for Payer: Priority Health Medicare |
$1,352.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,385.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,352.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.25
|
|
|
PR ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY
|
Professional
|
Both
|
$2,055.00
|
|
|
Service Code
|
HCPCS 43327
|
| Min. Negotiated Rate |
$521.85 |
| Max. Negotiated Rate |
$2,023.92 |
| Rate for Payer: Aetna Commercial |
$1,092.03
|
| Rate for Payer: Aetna Medicare |
$847.55
|
| Rate for Payer: BCBS Complete |
$547.94
|
| Rate for Payer: BCBS MAPPO |
$814.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.92
|
| Rate for Payer: BCN Commercial |
$1,197.26
|
| Rate for Payer: BCN Medicare Advantage |
$814.95
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cash Price |
$1,644.00
|
| Rate for Payer: Cofinity Commercial |
$1,173.53
|
| Rate for Payer: Cofinity Commercial |
$1,092.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$814.95
|
| Rate for Payer: Mclaren Medicaid |
$521.85
|
| Rate for Payer: Meridian Medicaid |
$547.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$855.70
|
| Rate for Payer: PACE SWMI |
$814.95
|
| Rate for Payer: PHP Medicare Advantage |
$814.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$521.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,440.54
|
| Rate for Payer: Priority Health Medicare |
$814.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,440.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$814.95
|
| Rate for Payer: UHC Medicare Advantage |
$839.40
|
|
|
PR ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 43460
|
| Min. Negotiated Rate |
$133.34 |
| Max. Negotiated Rate |
$1,198.18 |
| Rate for Payer: Aetna Commercial |
$276.33
|
| Rate for Payer: Aetna Medicare |
$214.47
|
| Rate for Payer: BCBS Complete |
$140.01
|
| Rate for Payer: BCBS MAPPO |
$206.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.18
|
| Rate for Payer: BCN Commercial |
$304.45
|
| Rate for Payer: BCN Medicare Advantage |
$206.22
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$296.96
|
| Rate for Payer: Cofinity Commercial |
$276.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.22
|
| Rate for Payer: Mclaren Medicaid |
$133.34
|
| Rate for Payer: Meridian Medicaid |
$140.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.53
|
| Rate for Payer: PACE SWMI |
$206.22
|
| Rate for Payer: PHP Medicare Advantage |
$206.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.31
|
| Rate for Payer: Priority Health Medicare |
$206.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.22
|
| Rate for Payer: UHC Medicare Advantage |
$212.41
|
|
|
PR ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 91013
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$1,265.81 |
| Rate for Payer: Aetna Commercial |
$32.66
|
| Rate for Payer: Aetna Medicare |
$25.34
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,265.81
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$32.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.58
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.37
|
| Rate for Payer: UHC Medicare Advantage |
$25.10
|
|
|
PR ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT
|
Professional
|
Both
|
$376.00
|
|
|
Service Code
|
HCPCS 91010
|
| Min. Negotiated Rate |
$47.55 |
| Max. Negotiated Rate |
$323.99 |
| Rate for Payer: Aetna Commercial |
$280.03
|
| Rate for Payer: Aetna Commercial |
$280.03
|
| Rate for Payer: Aetna Medicare |
$217.34
|
| Rate for Payer: Aetna Medicare |
$217.34
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS Complete |
$150.40
|
| Rate for Payer: BCBS MAPPO |
$208.98
|
| Rate for Payer: BCBS MAPPO |
$208.98
|
| Rate for Payer: BCBS Trust/PPO |
$47.55
|
| Rate for Payer: BCBS Trust/PPO |
$47.55
|
| Rate for Payer: BCN Commercial |
$323.99
|
| Rate for Payer: BCN Commercial |
$323.99
|
| Rate for Payer: BCN Medicare Advantage |
$208.98
|
| Rate for Payer: BCN Medicare Advantage |
$208.98
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$300.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$300.93
|
| Rate for Payer: Cofinity Commercial |
$280.03
|
| Rate for Payer: Cofinity Commercial |
$300.93
|
| Rate for Payer: Cofinity Commercial |
$280.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$219.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$219.43
|
| Rate for Payer: PACE SWMI |
$208.98
|
| Rate for Payer: PACE SWMI |
$208.98
|
| Rate for Payer: PHP Medicare Advantage |
$208.98
|
| Rate for Payer: PHP Medicare Advantage |
$208.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$297.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$297.78
|
| Rate for Payer: Priority Health Medicare |
$208.98
|
| Rate for Payer: Priority Health Medicare |
$208.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.98
|
| Rate for Payer: UHC Medicare Advantage |
$215.25
|
| Rate for Payer: UHC Medicare Advantage |
$215.25
|
|
|
PR ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ
|
Professional
|
Both
|
$6,395.00
|
|
|
Service Code
|
HCPCS 43287
|
| Min. Negotiated Rate |
$994.79 |
| Max. Negotiated Rate |
$6,148.42 |
| Rate for Payer: Aetna Commercial |
$4,694.29
|
| Rate for Payer: Aetna Medicare |
$3,643.33
|
| Rate for Payer: BCBS Complete |
$2,350.56
|
| Rate for Payer: BCBS MAPPO |
$3,503.20
|
| Rate for Payer: BCBS Trust/PPO |
$994.79
|
| Rate for Payer: BCN Commercial |
$5,110.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,503.20
|
| Rate for Payer: Cash Price |
$5,116.00
|
| Rate for Payer: Cash Price |
$5,116.00
|
| Rate for Payer: Cofinity Commercial |
$4,694.29
|
| Rate for Payer: Cofinity Commercial |
$5,044.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,503.20
|
| Rate for Payer: Mclaren Medicaid |
$2,238.63
|
| Rate for Payer: Meridian Medicaid |
$2,350.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,678.36
|
| Rate for Payer: PACE SWMI |
$3,503.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,503.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,238.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,148.42
|
| Rate for Payer: Priority Health Medicare |
$3,503.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,148.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,503.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,503.20
|
| Rate for Payer: UHC Medicare Advantage |
$3,608.30
|
|
|
PR ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ
|
Professional
|
Both
|
$6,475.00
|
|
|
Service Code
|
HCPCS 43286
|
| Min. Negotiated Rate |
$817.81 |
| Max. Negotiated Rate |
$5,529.88 |
| Rate for Payer: Aetna Commercial |
$4,212.61
|
| Rate for Payer: Aetna Medicare |
$3,269.49
|
| Rate for Payer: BCBS Complete |
$2,103.43
|
| Rate for Payer: BCBS MAPPO |
$3,143.74
|
| Rate for Payer: BCBS Trust/PPO |
$817.81
|
| Rate for Payer: BCN Commercial |
$4,596.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,143.74
|
| Rate for Payer: Cash Price |
$5,180.00
|
| Rate for Payer: Cash Price |
$5,180.00
|
| Rate for Payer: Cofinity Commercial |
$4,212.61
|
| Rate for Payer: Cofinity Commercial |
$4,526.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,143.74
|
| Rate for Payer: Mclaren Medicaid |
$2,003.27
|
| Rate for Payer: Meridian Medicaid |
$2,103.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,300.93
|
| Rate for Payer: PACE SWMI |
$3,143.74
|
| Rate for Payer: PHP Medicare Advantage |
$3,143.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,003.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,532.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,529.88
|
| Rate for Payer: Priority Health Medicare |
$3,143.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,529.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,143.74
|
| Rate for Payer: UHC Medicare Advantage |
$3,238.05
|
|
|
PR ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ
|
Professional
|
Both
|
$6,360.00
|
|
|
Service Code
|
HCPCS 43288
|
| Min. Negotiated Rate |
$1,474.49 |
| Max. Negotiated Rate |
$6,492.98 |
| Rate for Payer: Aetna Commercial |
$4,956.59
|
| Rate for Payer: Aetna Medicare |
$3,846.91
|
| Rate for Payer: BCBS Complete |
$2,478.93
|
| Rate for Payer: BCBS MAPPO |
$3,698.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,474.49
|
| Rate for Payer: BCN Commercial |
$5,396.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,698.95
|
| Rate for Payer: Cash Price |
$5,088.00
|
| Rate for Payer: Cash Price |
$5,088.00
|
| Rate for Payer: Cofinity Commercial |
$5,326.49
|
| Rate for Payer: Cofinity Commercial |
$4,956.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,698.95
|
| Rate for Payer: Mclaren Medicaid |
$2,360.89
|
| Rate for Payer: Meridian Medicaid |
$2,478.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,883.90
|
| Rate for Payer: PACE SWMI |
$3,698.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,698.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,360.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,452.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,492.98
|
| Rate for Payer: Priority Health Medicare |
$3,698.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,492.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,698.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,698.95
|
| Rate for Payer: UHC Medicare Advantage |
$3,809.92
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION
|
Professional
|
Both
|
$662.00
|
|
|
Service Code
|
HCPCS 43236
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$590.33 |
| Rate for Payer: Aetna Commercial |
$178.81
|
| Rate for Payer: Aetna Medicare |
$138.78
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$133.44
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$590.33
|
| Rate for Payer: BCN Medicare Advantage |
$133.44
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cash Price |
$529.60
|
| Rate for Payer: Cofinity Commercial |
$178.81
|
| Rate for Payer: Cofinity Commercial |
$192.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.44
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.11
|
| Rate for Payer: PACE SWMI |
$133.44
|
| Rate for Payer: PHP Medicare Advantage |
$133.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$463.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.53
|
| Rate for Payer: Priority Health Medicare |
$133.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.44
|
| Rate for Payer: UHC Medicare Advantage |
$137.44
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$709.00
|
|
|
Service Code
|
HCPCS 43235
|
| Hospital Charge Code |
43235
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$496.30 |
| Rate for Payer: Aetna Commercial |
$159.31
|
| Rate for Payer: Aetna Medicare |
$123.65
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$118.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$423.20
|
| Rate for Payer: BCN Medicare Advantage |
$118.89
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Cofinity Commercial |
$171.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.89
|
| Rate for Payer: Mclaren Medicaid |
$77.32
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.83
|
| Rate for Payer: PACE SWMI |
$118.89
|
| Rate for Payer: PHP Medicare Advantage |
$118.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.66
|
| Rate for Payer: Priority Health Medicare |
$118.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.89
|
| Rate for Payer: UHC Medicare Advantage |
$122.46
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$168.39 |
| Max. Negotiated Rate |
$638.10 |
| Rate for Payer: Aetna Commercial |
$602.65
|
| Rate for Payer: Aetna Medicare |
$184.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.56
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$177.25
|
| Rate for Payer: BCBS Trust/PPO |
$551.25
|
| Rate for Payer: BCN Commercial |
$551.25
|
| Rate for Payer: BCN Medicare Advantage |
$177.25
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cofinity Commercial |
$609.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$567.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.25
|
| Rate for Payer: Healthscope Commercial |
$638.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$531.75
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$602.65
|
| Rate for Payer: PACE Senior Care Partners |
$168.39
|
| Rate for Payer: PACE SWMI |
$177.25
|
| Rate for Payer: PHP Commercial |
$602.65
|
| Rate for Payer: PHP Medicare Advantage |
$177.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$616.83
|
| Rate for Payer: Priority Health Medicare |
$177.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.42
|
| Rate for Payer: Railroad Medicare Medicare |
$177.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.92
|
| Rate for Payer: UHC Core |
$592.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.25
|
| Rate for Payer: UHC Medicare Advantage |
$182.57
|
| Rate for Payer: VA VA |
$177.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$531.75
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$709.00
|
|
|
Service Code
|
HCPCS 43235
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$496.30 |
| Rate for Payer: Aetna Commercial |
$159.31
|
| Rate for Payer: Aetna Medicare |
$123.65
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$118.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$423.20
|
| Rate for Payer: BCN Medicare Advantage |
$118.89
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cofinity Commercial |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$159.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.89
|
| Rate for Payer: Mclaren Medicaid |
$77.32
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.83
|
| Rate for Payer: PACE SWMI |
$118.89
|
| Rate for Payer: PHP Medicare Advantage |
$118.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.66
|
| Rate for Payer: Priority Health Medicare |
$118.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.89
|
| Rate for Payer: UHC Medicare Advantage |
$122.46
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$432.42 |
| Max. Negotiated Rate |
$638.10 |
| Rate for Payer: Aetna Commercial |
$602.65
|
| Rate for Payer: BCBS Trust/PPO |
$547.92
|
| Rate for Payer: BCN Commercial |
$547.92
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cofinity Commercial |
$609.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$567.20
|
| Rate for Payer: Healthscope Commercial |
$638.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$531.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$602.65
|
| Rate for Payer: PHP Commercial |
$602.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$496.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$616.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$432.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$623.92
|
| Rate for Payer: UHC Core |
$592.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$531.75
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS
|
Professional
|
Both
|
$902.00
|
|
|
Service Code
|
HCPCS 43237
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$631.40 |
| Rate for Payer: Aetna Commercial |
$254.47
|
| Rate for Payer: Aetna Medicare |
$197.50
|
| Rate for Payer: BCBS Complete |
$129.04
|
| Rate for Payer: BCBS MAPPO |
$189.90
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$280.50
|
| Rate for Payer: BCN Medicare Advantage |
$189.90
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cofinity Commercial |
$273.46
|
| Rate for Payer: Cofinity Commercial |
$254.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.90
|
| Rate for Payer: Mclaren Medicaid |
$122.90
|
| Rate for Payer: Meridian Medicaid |
$129.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.40
|
| Rate for Payer: PACE SWMI |
$189.90
|
| Rate for Payer: PHP Medicare Advantage |
$189.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.49
|
| Rate for Payer: Priority Health Medicare |
$189.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$337.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.90
|
| Rate for Payer: UHC Medicare Advantage |
$195.60
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,321.00
|
|
|
Service Code
|
HCPCS 43330
|
| Min. Negotiated Rate |
$854.34 |
| Max. Negotiated Rate |
$2,635.16 |
| Rate for Payer: Aetna Commercial |
$1,782.31
|
| Rate for Payer: Aetna Medicare |
$1,383.28
|
| Rate for Payer: BCBS Complete |
$897.06
|
| Rate for Payer: BCBS MAPPO |
$1,330.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.16
|
| Rate for Payer: BCN Commercial |
$1,950.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,330.08
|
| Rate for Payer: Cash Price |
$1,856.80
|
| Rate for Payer: Cash Price |
$1,856.80
|
| Rate for Payer: Cofinity Commercial |
$1,782.31
|
| Rate for Payer: Cofinity Commercial |
$1,915.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,330.08
|
| Rate for Payer: Mclaren Medicaid |
$854.34
|
| Rate for Payer: Meridian Medicaid |
$897.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,396.58
|
| Rate for Payer: PACE SWMI |
$1,330.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,330.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$854.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,624.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,346.60
|
| Rate for Payer: Priority Health Medicare |
$1,330.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,346.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,330.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,330.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,369.98
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH
|
Professional
|
Both
|
$3,128.00
|
|
|
Service Code
|
HCPCS 43331
|
| Min. Negotiated Rate |
$648.75 |
| Max. Negotiated Rate |
$2,326.61 |
| Rate for Payer: Aetna Commercial |
$1,771.76
|
| Rate for Payer: Aetna Medicare |
$1,375.10
|
| Rate for Payer: BCBS Complete |
$889.46
|
| Rate for Payer: BCBS MAPPO |
$1,322.21
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: BCN Commercial |
$1,933.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,322.21
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cofinity Commercial |
$1,903.98
|
| Rate for Payer: Cofinity Commercial |
$1,771.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,322.21
|
| Rate for Payer: Mclaren Medicaid |
$847.10
|
| Rate for Payer: Meridian Medicaid |
$889.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,388.32
|
| Rate for Payer: PACE SWMI |
$1,322.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,322.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$847.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,326.61
|
| Rate for Payer: Priority Health Medicare |
$1,322.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,326.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,322.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,322.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,361.88
|
|
|
PR ESOPHAGOSCOPY,ABLATION TUMOR
|
Professional
|
Both
|
$1,412.00
|
|
|
Service Code
|
HCPCS 43228
|
| Min. Negotiated Rate |
$564.80 |
| Max. Negotiated Rate |
$988.40 |
| Rate for Payer: BCBS Complete |
$564.80
|
| Rate for Payer: Cash Price |
$1,129.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.40
|
|
