|
PR ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 43214
|
| Min. Negotiated Rate |
$122.48 |
| Max. Negotiated Rate |
$336.90 |
| Rate for Payer: Aetna Commercial |
$254.52
|
| Rate for Payer: Aetna Medicare |
$197.54
|
| Rate for Payer: BCBS Complete |
$128.60
|
| Rate for Payer: BCBS MAPPO |
$189.94
|
| Rate for Payer: BCBS Trust/PPO |
$167.47
|
| Rate for Payer: BCN Commercial |
$280.02
|
| Rate for Payer: BCN Medicare Advantage |
$189.94
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cofinity Commercial |
$273.51
|
| Rate for Payer: Cofinity Commercial |
$254.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.94
|
| Rate for Payer: Mclaren Medicaid |
$122.48
|
| Rate for Payer: Meridian Medicaid |
$128.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.44
|
| Rate for Payer: PACE SWMI |
$189.94
|
| Rate for Payer: PHP Medicare Advantage |
$189.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$336.90
|
| Rate for Payer: Priority Health Medicare |
$189.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.94
|
| Rate for Payer: UHC Medicare Advantage |
$195.64
|
|
|
PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM
|
Professional
|
Both
|
$1,488.00
|
|
|
Service Code
|
HCPCS 43220
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$1,333.11 |
| Rate for Payer: Aetna Commercial |
$153.64
|
| Rate for Payer: Aetna Medicare |
$119.25
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$114.66
|
| Rate for Payer: BCBS Trust/PPO |
$68.34
|
| Rate for Payer: BCN Commercial |
$1,333.11
|
| Rate for Payer: BCN Medicare Advantage |
$114.66
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cofinity Commercial |
$165.11
|
| Rate for Payer: Cofinity Commercial |
$153.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.66
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.39
|
| Rate for Payer: PACE SWMI |
$114.66
|
| Rate for Payer: PHP Medicare Advantage |
$114.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,041.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.03
|
| Rate for Payer: Priority Health Medicare |
$114.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.66
|
| Rate for Payer: UHC Medicare Advantage |
$118.10
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 43226
|
| Min. Negotiated Rate |
$82.43 |
| Max. Negotiated Rate |
$569.31 |
| Rate for Payer: Aetna Commercial |
$170.53
|
| Rate for Payer: Aetna Medicare |
$132.35
|
| Rate for Payer: BCBS Complete |
$86.55
|
| Rate for Payer: BCBS MAPPO |
$127.26
|
| Rate for Payer: BCBS Trust/PPO |
$127.32
|
| Rate for Payer: BCN Commercial |
$569.31
|
| Rate for Payer: BCN Medicare Advantage |
$127.26
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$170.53
|
| Rate for Payer: Cofinity Commercial |
$183.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.26
|
| Rate for Payer: Mclaren Medicaid |
$82.43
|
| Rate for Payer: Meridian Medicaid |
$86.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$133.62
|
| Rate for Payer: PACE SWMI |
$127.26
|
| Rate for Payer: PHP Medicare Advantage |
$127.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.79
|
| Rate for Payer: Priority Health Medicare |
$127.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.26
|
| Rate for Payer: UHC Medicare Advantage |
$131.08
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,032.00
|
|
|
Service Code
|
HCPCS 43215
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$722.40 |
| Rate for Payer: Aetna Commercial |
$184.30
|
| Rate for Payer: Aetna Medicare |
$143.04
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: BCBS MAPPO |
$137.54
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: BCN Medicare Advantage |
$137.54
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cofinity Commercial |
$184.30
|
| Rate for Payer: Cofinity Commercial |
$198.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.54
|
| Rate for Payer: Mclaren Medicaid |
$89.25
|
| Rate for Payer: Meridian Medicaid |
$93.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.42
|
| Rate for Payer: PACE SWMI |
$137.54
|
| Rate for Payer: PHP Medicare Advantage |
$137.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.01
|
| Rate for Payer: Priority Health Medicare |
$137.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.54
|
| Rate for Payer: UHC Medicare Advantage |
$141.67
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$1,032.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$245.10 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna Commercial |
$877.20
|
| Rate for Payer: Aetna Medicare |
$268.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.50
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$258.00
|
| Rate for Payer: BCBS Trust/PPO |
$802.38
|
| Rate for Payer: BCN Commercial |
$802.38
|
| Rate for Payer: BCN Medicare Advantage |
$258.00
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cofinity Commercial |
$887.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.00
|
| Rate for Payer: Healthscope Commercial |
$928.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.00
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$877.20
|
| Rate for Payer: PACE Senior Care Partners |
$245.10
|
| Rate for Payer: PACE SWMI |
$258.00
|
| Rate for Payer: PHP Commercial |
$877.20
|
| Rate for Payer: PHP Medicare Advantage |
$258.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.84
|
| Rate for Payer: Priority Health Medicare |
$258.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.42
|
| Rate for Payer: Railroad Medicare Medicare |
$258.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$908.16
|
| Rate for Payer: UHC Core |
$861.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.00
|
| Rate for Payer: UHC Medicare Advantage |
$265.74
|
| Rate for Payer: VA VA |
$258.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.00
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
IP
|
$1,032.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$629.42 |
| Max. Negotiated Rate |
$928.80 |
| Rate for Payer: Aetna Commercial |
$877.20
|
| Rate for Payer: BCBS Trust/PPO |
$797.53
|
| Rate for Payer: BCN Commercial |
$797.53
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cofinity Commercial |
$887.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.60
|
| Rate for Payer: Healthscope Commercial |
$928.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$877.20
|
| Rate for Payer: PHP Commercial |
$877.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$908.16
|
| Rate for Payer: UHC Core |
$861.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.00
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,032.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$722.40 |
| Rate for Payer: Aetna Commercial |
$184.30
|
| Rate for Payer: Aetna Medicare |
$143.04
|
| Rate for Payer: BCBS Complete |
$93.71
|
| Rate for Payer: BCBS MAPPO |
$137.54
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: BCN Medicare Advantage |
$137.54
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cash Price |
$825.60
|
| Rate for Payer: Cofinity Commercial |
$198.06
|
| Rate for Payer: Cofinity Commercial |
$184.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.54
|
| Rate for Payer: Mclaren Medicaid |
$89.25
|
| Rate for Payer: Meridian Medicaid |
$93.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.42
|
| Rate for Payer: PACE SWMI |
$137.54
|
| Rate for Payer: PHP Medicare Advantage |
$137.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$722.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.01
|
| Rate for Payer: Priority Health Medicare |
$137.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.54
|
| Rate for Payer: UHC Medicare Advantage |
$141.67
|
|
|
PR ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 43217
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$802.90 |
| Rate for Payer: Aetna Commercial |
$207.24
|
| Rate for Payer: Aetna Medicare |
$160.85
|
| Rate for Payer: BCBS Complete |
$105.79
|
| Rate for Payer: BCBS MAPPO |
$154.66
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$154.66
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$207.24
|
| Rate for Payer: Cofinity Commercial |
$222.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.66
|
| Rate for Payer: Mclaren Medicaid |
$100.75
|
| Rate for Payer: Meridian Medicaid |
$105.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.39
|
| Rate for Payer: PACE SWMI |
$154.66
|
| Rate for Payer: PHP Medicare Advantage |
$154.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.17
|
| Rate for Payer: Priority Health Medicare |
$154.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.66
|
| Rate for Payer: UHC Medicare Advantage |
$159.30
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$395.00
|
|
|
Service Code
|
HCPCS 43200
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$388.99 |
| Rate for Payer: Aetna Commercial |
$114.53
|
| Rate for Payer: Aetna Medicare |
$88.89
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$85.47
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$388.99
|
| Rate for Payer: BCN Medicare Advantage |
$85.47
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cash Price |
$316.00
|
| Rate for Payer: Cofinity Commercial |
$123.08
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.47
|
| Rate for Payer: Mclaren Medicaid |
$55.81
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.74
|
| Rate for Payer: PACE SWMI |
$85.47
|
| Rate for Payer: PHP Medicare Advantage |
$85.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.29
|
| Rate for Payer: Priority Health Medicare |
$85.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.47
|
| Rate for Payer: UHC Medicare Advantage |
$88.03
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM
|
Professional
|
Both
|
$867.00
|
|
|
Service Code
|
HCPCS 43231
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$606.90 |
| Rate for Payer: Aetna Commercial |
$205.10
|
| Rate for Payer: Aetna Medicare |
$159.18
|
| Rate for Payer: BCBS Complete |
$103.77
|
| Rate for Payer: BCBS MAPPO |
$153.06
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$153.06
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$205.10
|
| Rate for Payer: Cofinity Commercial |
$220.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.06
|
| Rate for Payer: Mclaren Medicaid |
$98.83
|
| Rate for Payer: Meridian Medicaid |
$103.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.71
|
| Rate for Payer: PACE SWMI |
$153.06
|
| Rate for Payer: PHP Medicare Advantage |
$153.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$272.24
|
| Rate for Payer: Priority Health Medicare |
$153.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$272.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.06
|
| Rate for Payer: UHC Medicare Advantage |
$157.65
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$541.80 |
| Rate for Payer: Aetna Commercial |
$134.01
|
| Rate for Payer: Aetna Medicare |
$104.01
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$100.01
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: BCN Medicare Advantage |
$100.01
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$144.01
|
| Rate for Payer: Cofinity Commercial |
$134.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.01
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.01
|
| Rate for Payer: PACE SWMI |
$100.01
|
| Rate for Payer: PHP Medicare Advantage |
$100.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.16
|
| Rate for Payer: Priority Health Medicare |
$100.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.01
|
| Rate for Payer: UHC Medicare Advantage |
$103.01
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$472.06 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Aetna Commercial |
$657.90
|
| Rate for Payer: BCBS Trust/PPO |
$598.15
|
| Rate for Payer: BCN Commercial |
$598.15
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$665.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.20
|
| Rate for Payer: Healthscope Commercial |
$696.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$657.90
|
| Rate for Payer: PHP Commercial |
$657.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$673.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.12
|
| Rate for Payer: UHC Core |
$646.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.50
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$183.82 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna Commercial |
$657.90
|
| Rate for Payer: Aetna Medicare |
$201.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$241.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$241.88
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$193.50
|
| Rate for Payer: BCBS Trust/PPO |
$601.78
|
| Rate for Payer: BCN Commercial |
$601.78
|
| Rate for Payer: BCN Medicare Advantage |
$193.50
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$665.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.50
|
| Rate for Payer: Healthscope Commercial |
$696.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.50
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$203.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$657.90
|
| Rate for Payer: PACE Senior Care Partners |
$183.82
|
| Rate for Payer: PACE SWMI |
$193.50
|
| Rate for Payer: PHP Commercial |
$657.90
|
| Rate for Payer: PHP Medicare Advantage |
$193.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$673.38
|
| Rate for Payer: Priority Health Medicare |
$193.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.06
|
| Rate for Payer: Railroad Medicare Medicare |
$193.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.12
|
| Rate for Payer: UHC Core |
$646.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.50
|
| Rate for Payer: UHC Medicare Advantage |
$199.30
|
| Rate for Payer: VA VA |
$193.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.50
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$774.00
|
|
|
Service Code
|
HCPCS 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$541.80 |
| Rate for Payer: Aetna Commercial |
$134.01
|
| Rate for Payer: Aetna Medicare |
$104.01
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$100.01
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: BCN Medicare Advantage |
$100.01
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cash Price |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$144.01
|
| Rate for Payer: Cofinity Commercial |
$134.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.01
|
| Rate for Payer: Mclaren Medicaid |
$65.18
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.01
|
| Rate for Payer: PACE SWMI |
$100.01
|
| Rate for Payer: PHP Medicare Advantage |
$100.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.16
|
| Rate for Payer: Priority Health Medicare |
$100.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.01
|
| Rate for Payer: UHC Medicare Advantage |
$103.01
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 43201
|
| Min. Negotiated Rate |
$30.11 |
| Max. Negotiated Rate |
$383.13 |
| Rate for Payer: Aetna Commercial |
$134.99
|
| Rate for Payer: Aetna Medicare |
$104.77
|
| Rate for Payer: BCBS Complete |
$68.88
|
| Rate for Payer: BCBS MAPPO |
$100.74
|
| Rate for Payer: BCBS Trust/PPO |
$30.11
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: BCN Medicare Advantage |
$100.74
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$145.07
|
| Rate for Payer: Cofinity Commercial |
$134.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.74
|
| Rate for Payer: Mclaren Medicaid |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$68.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.78
|
| Rate for Payer: PACE SWMI |
$100.74
|
| Rate for Payer: PHP Medicare Advantage |
$100.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.34
|
| Rate for Payer: Priority Health Medicare |
$100.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.74
|
| Rate for Payer: UHC Medicare Advantage |
$103.76
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43227
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$876.20 |
| Rate for Payer: Aetna Commercial |
$214.60
|
| Rate for Payer: Aetna Medicare |
$166.56
|
| Rate for Payer: BCBS Complete |
$109.14
|
| Rate for Payer: BCBS MAPPO |
$160.15
|
| Rate for Payer: BCBS Trust/PPO |
$43.32
|
| Rate for Payer: BCN Commercial |
$876.20
|
| Rate for Payer: BCN Medicare Advantage |
$160.15
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$214.60
|
| Rate for Payer: Cofinity Commercial |
$230.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.15
|
| Rate for Payer: Mclaren Medicaid |
$103.94
|
| Rate for Payer: Meridian Medicaid |
$109.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.16
|
| Rate for Payer: PACE SWMI |
$160.15
|
| Rate for Payer: PHP Medicare Advantage |
$160.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.57
|
| Rate for Payer: Priority Health Medicare |
$160.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.15
|
| Rate for Payer: UHC Medicare Advantage |
$164.95
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43204
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$757.40 |
| Rate for Payer: Aetna Commercial |
$175.67
|
| Rate for Payer: Aetna Medicare |
$136.34
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$131.10
|
| Rate for Payer: BCBS Trust/PPO |
$249.36
|
| Rate for Payer: BCN Commercial |
$194.01
|
| Rate for Payer: BCN Medicare Advantage |
$131.10
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$188.78
|
| Rate for Payer: Cofinity Commercial |
$175.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.10
|
| Rate for Payer: Mclaren Medicaid |
$84.99
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.66
|
| Rate for Payer: PACE SWMI |
$131.10
|
| Rate for Payer: PHP Medicare Advantage |
$131.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.42
|
| Rate for Payer: Priority Health Medicare |
$131.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.10
|
| Rate for Payer: UHC Medicare Advantage |
$135.03
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION
|
Professional
|
Both
|
$626.00
|
|
|
Service Code
|
HCPCS 43229
|
| Min. Negotiated Rate |
$123.53 |
| Max. Negotiated Rate |
$1,048.21 |
| Rate for Payer: Aetna Commercial |
$256.02
|
| Rate for Payer: Aetna Medicare |
$198.70
|
| Rate for Payer: BCBS Complete |
$129.94
|
| Rate for Payer: BCBS MAPPO |
$191.06
|
| Rate for Payer: BCBS Trust/PPO |
$123.53
|
| Rate for Payer: BCN Commercial |
$1,048.21
|
| Rate for Payer: BCN Medicare Advantage |
$191.06
|
| Rate for Payer: Cash Price |
$500.80
|
| Rate for Payer: Cash Price |
$500.80
|
| Rate for Payer: Cofinity Commercial |
$275.13
|
| Rate for Payer: Cofinity Commercial |
$256.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.06
|
| Rate for Payer: Mclaren Medicaid |
$123.75
|
| Rate for Payer: Meridian Medicaid |
$129.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.61
|
| Rate for Payer: PACE SWMI |
$191.06
|
| Rate for Payer: PHP Medicare Advantage |
$191.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$438.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.26
|
| Rate for Payer: Priority Health Medicare |
$191.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$339.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.06
|
| Rate for Payer: UHC Medicare Advantage |
$196.79
|
|
|
PR ESOPHAGOSCOPY,INSERT TUBE/STENT
|
Professional
|
Both
|
$1,467.00
|
|
|
Service Code
|
HCPCS 43219
|
| Min. Negotiated Rate |
$586.80 |
| Max. Negotiated Rate |
$1,026.90 |
| Rate for Payer: BCBS Complete |
$586.80
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,026.90
|
|
|
PR ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX
|
Professional
|
Both
|
$1,014.00
|
|
|
Service Code
|
HCPCS 43232
|
| Min. Negotiated Rate |
$81.89 |
| Max. Negotiated Rate |
$709.80 |
| Rate for Payer: Aetna Commercial |
$256.88
|
| Rate for Payer: Aetna Medicare |
$199.37
|
| Rate for Payer: BCBS Complete |
$131.28
|
| Rate for Payer: BCBS MAPPO |
$191.70
|
| Rate for Payer: BCBS Trust/PPO |
$81.89
|
| Rate for Payer: BCN Commercial |
$282.95
|
| Rate for Payer: BCN Medicare Advantage |
$191.70
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cash Price |
$811.20
|
| Rate for Payer: Cofinity Commercial |
$276.05
|
| Rate for Payer: Cofinity Commercial |
$256.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.70
|
| Rate for Payer: Mclaren Medicaid |
$125.03
|
| Rate for Payer: Meridian Medicaid |
$131.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.28
|
| Rate for Payer: PACE SWMI |
$191.70
|
| Rate for Payer: PHP Medicare Advantage |
$191.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$709.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.44
|
| Rate for Payer: Priority Health Medicare |
$191.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.70
|
| Rate for Payer: UHC Medicare Advantage |
$197.45
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 43195
|
| Min. Negotiated Rate |
$29.06 |
| Max. Negotiated Rate |
$323.98 |
| Rate for Payer: Aetna Commercial |
$243.64
|
| Rate for Payer: Aetna Medicare |
$189.09
|
| Rate for Payer: BCBS Complete |
$123.90
|
| Rate for Payer: BCBS MAPPO |
$181.82
|
| Rate for Payer: BCBS Trust/PPO |
$29.06
|
| Rate for Payer: BCN Commercial |
$269.26
|
| Rate for Payer: BCN Medicare Advantage |
$181.82
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$243.64
|
| Rate for Payer: Cofinity Commercial |
$261.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.82
|
| Rate for Payer: Mclaren Medicaid |
$118.00
|
| Rate for Payer: Meridian Medicaid |
$123.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.91
|
| Rate for Payer: PACE SWMI |
$181.82
|
| Rate for Payer: PHP Medicare Advantage |
$181.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.98
|
| Rate for Payer: Priority Health Medicare |
$181.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$323.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.82
|
| Rate for Payer: UHC Medicare Advantage |
$187.27
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 43191
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$275.80 |
| Rate for Payer: Aetna Commercial |
$204.36
|
| Rate for Payer: Aetna Medicare |
$158.61
|
| Rate for Payer: BCBS Complete |
$104.22
|
| Rate for Payer: BCBS MAPPO |
$152.51
|
| Rate for Payer: BCBS Trust/PPO |
$63.92
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$152.51
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$219.61
|
| Rate for Payer: Cofinity Commercial |
$204.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.51
|
| Rate for Payer: Mclaren Medicaid |
$99.26
|
| Rate for Payer: Meridian Medicaid |
$104.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.14
|
| Rate for Payer: PACE SWMI |
$152.51
|
| Rate for Payer: PHP Medicare Advantage |
$152.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$272.24
|
| Rate for Payer: Priority Health Medicare |
$152.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$272.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.51
|
| Rate for Payer: UHC Medicare Advantage |
$157.09
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL
|
Professional
|
Both
|
$337.00
|
|
|
Service Code
|
HCPCS 43192
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$297.52 |
| Rate for Payer: Aetna Commercial |
$223.67
|
| Rate for Payer: Aetna Medicare |
$173.60
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: BCBS MAPPO |
$166.92
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$247.27
|
| Rate for Payer: BCN Medicare Advantage |
$166.92
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cash Price |
$269.60
|
| Rate for Payer: Cofinity Commercial |
$240.36
|
| Rate for Payer: Cofinity Commercial |
$223.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.92
|
| Rate for Payer: Mclaren Medicaid |
$108.42
|
| Rate for Payer: Meridian Medicaid |
$113.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$175.27
|
| Rate for Payer: PACE SWMI |
$166.92
|
| Rate for Payer: PHP Medicare Advantage |
$166.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$297.52
|
| Rate for Payer: Priority Health Medicare |
$166.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.92
|
| Rate for Payer: UHC Medicare Advantage |
$171.93
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 43193
|
| Min. Negotiated Rate |
$46.49 |
| Max. Negotiated Rate |
$364.70 |
| Rate for Payer: Aetna Commercial |
$222.76
|
| Rate for Payer: Aetna Medicare |
$172.89
|
| Rate for Payer: BCBS Complete |
$113.39
|
| Rate for Payer: BCBS MAPPO |
$166.24
|
| Rate for Payer: BCBS Trust/PPO |
$46.49
|
| Rate for Payer: BCN Commercial |
$246.29
|
| Rate for Payer: BCN Medicare Advantage |
$166.24
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$239.39
|
| Rate for Payer: Cofinity Commercial |
$222.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.24
|
| Rate for Payer: Mclaren Medicaid |
$107.99
|
| Rate for Payer: Meridian Medicaid |
$113.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.55
|
| Rate for Payer: PACE SWMI |
$166.24
|
| Rate for Payer: PHP Medicare Advantage |
$166.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$296.34
|
| Rate for Payer: Priority Health Medicare |
$166.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$296.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.24
|
| Rate for Payer: UHC Medicare Advantage |
$171.23
|
|
|
PR ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 43194
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$336.31 |
| Rate for Payer: Aetna Commercial |
$255.15
|
| Rate for Payer: Aetna Medicare |
$198.03
|
| Rate for Payer: BCBS Complete |
$127.03
|
| Rate for Payer: BCBS MAPPO |
$190.41
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$279.53
|
| Rate for Payer: BCN Medicare Advantage |
$190.41
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$274.19
|
| Rate for Payer: Cofinity Commercial |
$255.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.41
|
| Rate for Payer: Mclaren Medicaid |
$120.98
|
| Rate for Payer: Meridian Medicaid |
$127.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.93
|
| Rate for Payer: PACE SWMI |
$190.41
|
| Rate for Payer: PHP Medicare Advantage |
$190.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$336.31
|
| Rate for Payer: Priority Health Medicare |
$190.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.41
|
| Rate for Payer: UHC Medicare Advantage |
$196.12
|
|
