|
PR EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 43243
|
| Min. Negotiated Rate |
$70.26 |
| Max. Negotiated Rate |
$782.60 |
| Rate for Payer: Aetna Commercial |
$301.16
|
| Rate for Payer: Aetna Medicare |
$233.74
|
| Rate for Payer: BCBS Complete |
$157.45
|
| Rate for Payer: BCBS MAPPO |
$224.75
|
| Rate for Payer: BCBS Trust/PPO |
$70.26
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: BCN Medicare Advantage |
$224.75
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$323.64
|
| Rate for Payer: Cofinity Commercial |
$301.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.75
|
| Rate for Payer: Mclaren Medicaid |
$149.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.99
|
| Rate for Payer: Meridian Medicaid |
$157.45
|
| Rate for Payer: Nomi Health Commercial |
$269.70
|
| Rate for Payer: PACE SWMI |
$224.75
|
| Rate for Payer: PHP Medicare Advantage |
$224.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO |
$418.22
|
| Rate for Payer: Priority Health Medicare |
$227.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.75
|
| Rate for Payer: UHC Exchange |
$224.75
|
| Rate for Payer: UHC Medicare Advantage |
$224.75
|
| Rate for Payer: UHCCP Medicaid |
$149.95
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
OP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$209.95 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: Aetna Commercial |
$751.40
|
| Rate for Payer: Aetna Medicare |
$229.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.25
|
| Rate for Payer: BCBS Complete |
$697.40
|
| Rate for Payer: BCBS MAPPO |
$221.00
|
| Rate for Payer: BCBS Trust/PPO |
$726.74
|
| Rate for Payer: BCN Commercial |
$687.31
|
| Rate for Payer: BCN Medicare Advantage |
$221.00
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$760.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.00
|
| Rate for Payer: Healthscope Commercial |
$795.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.00
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.05
|
| Rate for Payer: Meridian Medicaid |
$697.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: Nomi Health Commercial |
$724.88
|
| Rate for Payer: PACE Senior Care Partners |
$209.95
|
| Rate for Payer: PACE SWMI |
$221.00
|
| Rate for Payer: PHP Commercial |
$751.40
|
| Rate for Payer: PHP Medicare Advantage |
$221.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO |
$769.08
|
| Rate for Payer: Priority Health Medicare |
$223.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$592.28
|
| Rate for Payer: Railroad Medicare Medicare |
$221.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.92
|
| Rate for Payer: UHC Core |
$738.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.00
|
| Rate for Payer: UHC Exchange |
$221.00
|
| Rate for Payer: UHC Medicare Advantage |
$221.00
|
| Rate for Payer: UHCCP Medicaid |
$664.15
|
| Rate for Payer: VA VA |
$221.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.00
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Facility
|
IP
|
$884.00
|
|
|
Service Code
|
CPT 43248
|
| Hospital Charge Code |
43248
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$574.60 |
| Max. Negotiated Rate |
$795.60 |
| Rate for Payer: Aetna Commercial |
$751.40
|
| Rate for Payer: BCBS Trust/PPO |
$721.61
|
| Rate for Payer: BCN Commercial |
$683.16
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$760.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.20
|
| Rate for Payer: Healthscope Commercial |
$795.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.40
|
| Rate for Payer: Nomi Health Commercial |
$724.88
|
| Rate for Payer: PHP Commercial |
$751.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO |
$769.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$592.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.92
|
| Rate for Payer: UHC Core |
$738.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.00
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Min. Negotiated Rate |
$104.80 |
| Max. Negotiated Rate |
$607.43 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$162.67
|
| Rate for Payer: BCBS Complete |
$110.04
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Mclaren Medicaid |
$104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Meridian Medicaid |
$110.04
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO |
$292.92
|
| Rate for Payer: Priority Health Medicare |
$157.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Exchange |
$156.41
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
| Rate for Payer: UHCCP Medicaid |
$104.80
|
|
|
PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43248
|
| Hospital Charge Code |
43248
|
| Min. Negotiated Rate |
$104.80 |
| Max. Negotiated Rate |
$607.43 |
| Rate for Payer: Aetna Commercial |
$209.59
|
| Rate for Payer: Aetna Medicare |
$162.67
|
| Rate for Payer: BCBS Complete |
$110.04
|
| Rate for Payer: BCBS MAPPO |
$156.41
|
| Rate for Payer: BCBS Trust/PPO |
$120.98
|
| Rate for Payer: BCN Commercial |
$607.43
|
| Rate for Payer: BCN Medicare Advantage |
$156.41
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$225.23
|
| Rate for Payer: Cofinity Commercial |
$209.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.41
|
| Rate for Payer: Mclaren Medicaid |
$104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.23
|
| Rate for Payer: Meridian Medicaid |
$110.04
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: PACE SWMI |
$156.41
|
| Rate for Payer: PHP Medicare Advantage |
$156.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO |
$292.92
|
| Rate for Payer: Priority Health Medicare |
$157.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.41
|
| Rate for Payer: UHC Exchange |
$156.41
|
| Rate for Payer: UHC Medicare Advantage |
$156.41
|
| Rate for Payer: UHCCP Medicaid |
$104.80
|
|
|
PR EGD INTRALUMINAL TUBE/CATHETER INSERTION
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 43241
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$567.45 |
| Rate for Payer: Aetna Commercial |
$180.38
|
| Rate for Payer: Aetna Medicare |
$139.99
|
| Rate for Payer: BCBS Complete |
$94.60
|
| Rate for Payer: BCBS MAPPO |
$134.61
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: BCN Medicare Advantage |
$134.61
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$193.84
|
| Rate for Payer: Cofinity Commercial |
$180.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.61
|
| Rate for Payer: Mclaren Medicaid |
$90.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.34
|
| Rate for Payer: Meridian Medicaid |
$94.60
|
| Rate for Payer: Nomi Health Commercial |
$161.53
|
| Rate for Payer: PACE SWMI |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$134.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.45
|
| Rate for Payer: Priority Health HMO/PPO |
$251.17
|
| Rate for Payer: Priority Health Medicare |
$135.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.61
|
| Rate for Payer: UHC Exchange |
$134.61
|
| Rate for Payer: UHC Medicare Advantage |
$134.61
|
| Rate for Payer: UHCCP Medicaid |
$90.10
|
|
|
PR EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY
|
Professional
|
Both
|
$1,033.00
|
|
|
Service Code
|
HCPCS 43242
|
| Min. Negotiated Rate |
$51.77 |
| Max. Negotiated Rate |
$671.45 |
| Rate for Payer: Aetna Commercial |
$330.51
|
| Rate for Payer: Aetna Medicare |
$256.52
|
| Rate for Payer: BCBS Complete |
$173.33
|
| Rate for Payer: BCBS MAPPO |
$246.65
|
| Rate for Payer: BCBS Trust/PPO |
$51.77
|
| Rate for Payer: BCN Commercial |
$376.77
|
| Rate for Payer: BCN Medicare Advantage |
$246.65
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cash Price |
$826.40
|
| Rate for Payer: Cofinity Commercial |
$355.18
|
| Rate for Payer: Cofinity Commercial |
$330.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.65
|
| Rate for Payer: Mclaren Medicaid |
$165.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.98
|
| Rate for Payer: Meridian Medicaid |
$173.33
|
| Rate for Payer: Nomi Health Commercial |
$295.98
|
| Rate for Payer: PACE SWMI |
$246.65
|
| Rate for Payer: PHP Medicare Advantage |
$246.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.45
|
| Rate for Payer: Priority Health HMO/PPO |
$461.77
|
| Rate for Payer: Priority Health Medicare |
$249.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.65
|
| Rate for Payer: UHC Exchange |
$246.65
|
| Rate for Payer: UHC Medicare Advantage |
$246.65
|
| Rate for Payer: UHCCP Medicaid |
$165.08
|
|
|
PR EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 43238
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$673.40 |
| Rate for Payer: Aetna Commercial |
$293.39
|
| Rate for Payer: Aetna Medicare |
$227.71
|
| Rate for Payer: BCBS Complete |
$153.87
|
| Rate for Payer: BCBS MAPPO |
$218.95
|
| Rate for Payer: BCBS Trust/PPO |
$14.01
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: BCN Medicare Advantage |
$218.95
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$315.29
|
| Rate for Payer: Cofinity Commercial |
$293.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.95
|
| Rate for Payer: Mclaren Medicaid |
$146.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.90
|
| Rate for Payer: Meridian Medicaid |
$153.87
|
| Rate for Payer: Nomi Health Commercial |
$262.74
|
| Rate for Payer: PACE SWMI |
$218.95
|
| Rate for Payer: PHP Medicare Advantage |
$218.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$673.40
|
| Rate for Payer: Priority Health HMO/PPO |
$408.08
|
| Rate for Payer: Priority Health Medicare |
$221.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$408.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.95
|
| Rate for Payer: UHC Exchange |
$218.95
|
| Rate for Payer: UHC Medicare Advantage |
$218.95
|
| Rate for Payer: UHCCP Medicaid |
$146.54
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
43246
|
| Min. Negotiated Rate |
$69.74 |
| Max. Negotiated Rate |
$939.90 |
| Rate for Payer: Aetna Commercial |
$254.53
|
| Rate for Payer: Aetna Medicare |
$197.55
|
| Rate for Payer: BCBS Complete |
$132.85
|
| Rate for Payer: BCBS MAPPO |
$189.95
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$189.95
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$273.53
|
| Rate for Payer: Cofinity Commercial |
$254.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.95
|
| Rate for Payer: Mclaren Medicaid |
$126.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.45
|
| Rate for Payer: Meridian Medicaid |
$132.85
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE SWMI |
$189.95
|
| Rate for Payer: PHP Medicare Advantage |
$189.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO |
$353.18
|
| Rate for Payer: Priority Health Medicare |
$191.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.95
|
| Rate for Payer: UHC Exchange |
$189.95
|
| Rate for Payer: UHC Medicare Advantage |
$189.95
|
| Rate for Payer: UHCCP Medicaid |
$126.52
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
IP
|
$1,446.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$939.90 |
| Max. Negotiated Rate |
$1,301.40 |
| Rate for Payer: Aetna Commercial |
$1,229.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.37
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,243.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.80
|
| Rate for Payer: Healthscope Commercial |
$1,301.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,084.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,229.10
|
| Rate for Payer: Nomi Health Commercial |
$1,185.72
|
| Rate for Payer: PHP Commercial |
$1,229.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,258.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$968.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.48
|
| Rate for Payer: UHC Core |
$1,207.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,084.50
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,446.00
|
|
|
Service Code
|
HCPCS 43246
|
| Min. Negotiated Rate |
$69.74 |
| Max. Negotiated Rate |
$939.90 |
| Rate for Payer: Aetna Commercial |
$254.53
|
| Rate for Payer: Aetna Medicare |
$197.55
|
| Rate for Payer: BCBS Complete |
$132.85
|
| Rate for Payer: BCBS MAPPO |
$189.95
|
| Rate for Payer: BCBS Trust/PPO |
$69.74
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$189.95
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$273.53
|
| Rate for Payer: Cofinity Commercial |
$254.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.95
|
| Rate for Payer: Mclaren Medicaid |
$126.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.45
|
| Rate for Payer: Meridian Medicaid |
$132.85
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE SWMI |
$189.95
|
| Rate for Payer: PHP Medicare Advantage |
$189.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO |
$353.18
|
| Rate for Payer: Priority Health Medicare |
$191.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.95
|
| Rate for Payer: UHC Exchange |
$189.95
|
| Rate for Payer: UHC Medicare Advantage |
$189.95
|
| Rate for Payer: UHCCP Medicaid |
$126.52
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
OP
|
$1,446.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$343.42 |
| Max. Negotiated Rate |
$1,411.07 |
| Rate for Payer: Aetna Commercial |
$1,229.10
|
| Rate for Payer: Aetna Medicare |
$375.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$451.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$451.88
|
| Rate for Payer: BCBS Complete |
$1,411.07
|
| Rate for Payer: BCBS MAPPO |
$361.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.76
|
| Rate for Payer: BCN Commercial |
$1,124.26
|
| Rate for Payer: BCN Medicare Advantage |
$361.50
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cash Price |
$1,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,243.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.50
|
| Rate for Payer: Healthscope Commercial |
$1,301.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,084.50
|
| Rate for Payer: Mclaren Medicaid |
$1,343.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.58
|
| Rate for Payer: Meridian Medicaid |
$1,411.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$415.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,229.10
|
| Rate for Payer: Nomi Health Commercial |
$1,185.72
|
| Rate for Payer: PACE Senior Care Partners |
$343.42
|
| Rate for Payer: PACE SWMI |
$361.50
|
| Rate for Payer: PHP Commercial |
$1,229.10
|
| Rate for Payer: PHP Medicare Advantage |
$361.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,343.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,258.02
|
| Rate for Payer: Priority Health Medicare |
$365.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$968.82
|
| Rate for Payer: Railroad Medicare Medicare |
$361.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.48
|
| Rate for Payer: UHC Core |
$1,207.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.50
|
| Rate for Payer: UHC Exchange |
$361.50
|
| Rate for Payer: UHC Medicare Advantage |
$361.50
|
| Rate for Payer: UHCCP Medicaid |
$1,343.79
|
| Rate for Payer: VA VA |
$361.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,084.50
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 43251
|
| Hospital Charge Code |
43251
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$775.45 |
| Rate for Payer: Aetna Commercial |
$247.30
|
| Rate for Payer: Aetna Medicare |
$191.93
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS MAPPO |
$184.55
|
| Rate for Payer: BCBS Trust/PPO |
$748.60
|
| Rate for Payer: BCN Commercial |
$729.10
|
| Rate for Payer: BCN Medicare Advantage |
$184.55
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$265.75
|
| Rate for Payer: Cofinity Commercial |
$247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.55
|
| Rate for Payer: Mclaren Medicaid |
$123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.78
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Nomi Health Commercial |
$221.46
|
| Rate for Payer: PACE SWMI |
$184.55
|
| Rate for Payer: PHP Medicare Advantage |
$184.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO |
$344.83
|
| Rate for Payer: Priority Health Medicare |
$186.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.55
|
| Rate for Payer: UHC Exchange |
$184.55
|
| Rate for Payer: UHC Medicare Advantage |
$184.55
|
| Rate for Payer: UHCCP Medicaid |
$123.54
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,193.00
|
|
|
Service Code
|
HCPCS 43251
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$775.45 |
| Rate for Payer: Aetna Commercial |
$247.30
|
| Rate for Payer: Aetna Medicare |
$191.93
|
| Rate for Payer: BCBS Complete |
$129.72
|
| Rate for Payer: BCBS MAPPO |
$184.55
|
| Rate for Payer: BCBS Trust/PPO |
$748.60
|
| Rate for Payer: BCN Commercial |
$729.10
|
| Rate for Payer: BCN Medicare Advantage |
$184.55
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$265.75
|
| Rate for Payer: Cofinity Commercial |
$247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.55
|
| Rate for Payer: Mclaren Medicaid |
$123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.78
|
| Rate for Payer: Meridian Medicaid |
$129.72
|
| Rate for Payer: Nomi Health Commercial |
$221.46
|
| Rate for Payer: PACE SWMI |
$184.55
|
| Rate for Payer: PHP Medicare Advantage |
$184.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO |
$344.83
|
| Rate for Payer: Priority Health Medicare |
$186.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.55
|
| Rate for Payer: UHC Exchange |
$184.55
|
| Rate for Payer: UHC Medicare Advantage |
$184.55
|
| Rate for Payer: UHCCP Medicaid |
$123.54
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
IP
|
$1,193.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$775.45 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Aetna Commercial |
$1,014.05
|
| Rate for Payer: BCBS Trust/PPO |
$973.85
|
| Rate for Payer: BCN Commercial |
$921.95
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.40
|
| Rate for Payer: Healthscope Commercial |
$1,073.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$894.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.05
|
| Rate for Payer: Nomi Health Commercial |
$978.26
|
| Rate for Payer: PHP Commercial |
$1,014.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,037.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$799.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,049.84
|
| Rate for Payer: UHC Core |
$996.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$894.75
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
OP
|
$1,193.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$283.34 |
| Max. Negotiated Rate |
$1,411.07 |
| Rate for Payer: Aetna Commercial |
$1,014.05
|
| Rate for Payer: Aetna Medicare |
$310.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.81
|
| Rate for Payer: BCBS Complete |
$1,411.07
|
| Rate for Payer: BCBS MAPPO |
$298.25
|
| Rate for Payer: BCBS Trust/PPO |
$980.77
|
| Rate for Payer: BCN Commercial |
$927.56
|
| Rate for Payer: BCN Medicare Advantage |
$298.25
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cash Price |
$954.40
|
| Rate for Payer: Cofinity Commercial |
$1,025.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$954.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.25
|
| Rate for Payer: Healthscope Commercial |
$1,073.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$894.75
|
| Rate for Payer: Mclaren Medicaid |
$1,343.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.16
|
| Rate for Payer: Meridian Medicaid |
$1,411.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,014.05
|
| Rate for Payer: Nomi Health Commercial |
$978.26
|
| Rate for Payer: PACE Senior Care Partners |
$283.34
|
| Rate for Payer: PACE SWMI |
$298.25
|
| Rate for Payer: PHP Commercial |
$1,014.05
|
| Rate for Payer: PHP Medicare Advantage |
$298.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,343.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$775.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,037.91
|
| Rate for Payer: Priority Health Medicare |
$301.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$799.31
|
| Rate for Payer: Railroad Medicare Medicare |
$298.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,049.84
|
| Rate for Payer: UHC Core |
$996.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.25
|
| Rate for Payer: UHC Exchange |
$298.25
|
| Rate for Payer: UHC Medicare Advantage |
$298.25
|
| Rate for Payer: UHCCP Medicaid |
$1,343.79
|
| Rate for Payer: VA VA |
$298.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$894.75
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$199.02 |
| Max. Negotiated Rate |
$754.20 |
| Rate for Payer: Aetna Commercial |
$712.30
|
| Rate for Payer: Aetna Medicare |
$217.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$261.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$261.88
|
| Rate for Payer: BCBS Complete |
$697.40
|
| Rate for Payer: BCBS MAPPO |
$209.50
|
| Rate for Payer: BCBS Trust/PPO |
$688.92
|
| Rate for Payer: BCN Commercial |
$651.54
|
| Rate for Payer: BCN Medicare Advantage |
$209.50
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$720.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.50
|
| Rate for Payer: Healthscope Commercial |
$754.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$628.50
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.98
|
| Rate for Payer: Meridian Medicaid |
$697.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.30
|
| Rate for Payer: Nomi Health Commercial |
$687.16
|
| Rate for Payer: PACE Senior Care Partners |
$199.02
|
| Rate for Payer: PACE SWMI |
$209.50
|
| Rate for Payer: PHP Commercial |
$712.30
|
| Rate for Payer: PHP Medicare Advantage |
$209.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO |
$729.06
|
| Rate for Payer: Priority Health Medicare |
$211.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.46
|
| Rate for Payer: Railroad Medicare Medicare |
$209.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$737.44
|
| Rate for Payer: UHC Core |
$699.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.50
|
| Rate for Payer: UHC Exchange |
$209.50
|
| Rate for Payer: UHC Medicare Advantage |
$209.50
|
| Rate for Payer: UHCCP Medicaid |
$664.15
|
| Rate for Payer: VA VA |
$209.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$628.50
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 43239
|
| Hospital Charge Code |
43239
|
| Min. Negotiated Rate |
$33.11 |
| Max. Negotiated Rate |
$554.16 |
| Rate for Payer: Aetna Commercial |
$174.41
|
| Rate for Payer: Aetna Medicare |
$135.37
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$130.16
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$554.16
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Cofinity Commercial |
$174.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.67
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Nomi Health Commercial |
$156.19
|
| Rate for Payer: PACE SWMI |
$130.16
|
| Rate for Payer: PHP Medicare Advantage |
$130.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO |
$244.61
|
| Rate for Payer: Priority Health Medicare |
$131.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Exchange |
$130.16
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$544.70 |
| Max. Negotiated Rate |
$754.20 |
| Rate for Payer: Aetna Commercial |
$712.30
|
| Rate for Payer: BCBS Trust/PPO |
$684.06
|
| Rate for Payer: BCN Commercial |
$647.61
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$720.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.40
|
| Rate for Payer: Healthscope Commercial |
$754.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$628.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.30
|
| Rate for Payer: Nomi Health Commercial |
$687.16
|
| Rate for Payer: PHP Commercial |
$712.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO |
$729.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$737.44
|
| Rate for Payer: UHC Core |
$699.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$628.50
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 43239
|
| Min. Negotiated Rate |
$33.11 |
| Max. Negotiated Rate |
$554.16 |
| Rate for Payer: Aetna Commercial |
$174.41
|
| Rate for Payer: Aetna Medicare |
$135.37
|
| Rate for Payer: BCBS Complete |
$91.70
|
| Rate for Payer: BCBS MAPPO |
$130.16
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$554.16
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Cofinity Commercial |
$174.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| Rate for Payer: Mclaren Medicaid |
$87.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.67
|
| Rate for Payer: Meridian Medicaid |
$91.70
|
| Rate for Payer: Nomi Health Commercial |
$156.19
|
| Rate for Payer: PACE SWMI |
$130.16
|
| Rate for Payer: PHP Medicare Advantage |
$130.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO |
$244.61
|
| Rate for Payer: Priority Health Medicare |
$131.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Exchange |
$130.16
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
|
|
PR EGD TRANSORAL CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 43255
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$935.09 |
| Rate for Payer: Aetna Commercial |
$252.66
|
| Rate for Payer: Aetna Medicare |
$196.09
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$188.55
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$923.11
|
| Rate for Payer: BCN Medicare Advantage |
$188.55
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$271.51
|
| Rate for Payer: Cofinity Commercial |
$252.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.55
|
| Rate for Payer: Mclaren Medicaid |
$126.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.98
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Nomi Health Commercial |
$226.26
|
| Rate for Payer: PACE SWMI |
$188.55
|
| Rate for Payer: PHP Medicare Advantage |
$188.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.45
|
| Rate for Payer: Priority Health HMO/PPO |
$352.00
|
| Rate for Payer: Priority Health Medicare |
$190.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.55
|
| Rate for Payer: UHC Exchange |
$188.55
|
| Rate for Payer: UHC Medicare Advantage |
$188.55
|
| Rate for Payer: UHCCP Medicaid |
$126.31
|
|
|
PR EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$834.00
|
|
|
Service Code
|
HCPCS 43254
|
| Min. Negotiated Rate |
$169.97 |
| Max. Negotiated Rate |
$1,640.37 |
| Rate for Payer: Aetna Commercial |
$340.48
|
| Rate for Payer: Aetna Medicare |
$264.25
|
| Rate for Payer: BCBS Complete |
$178.47
|
| Rate for Payer: BCBS MAPPO |
$254.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.37
|
| Rate for Payer: BCN Commercial |
$386.55
|
| Rate for Payer: BCN Medicare Advantage |
$254.09
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cash Price |
$667.20
|
| Rate for Payer: Cofinity Commercial |
$365.89
|
| Rate for Payer: Cofinity Commercial |
$340.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.09
|
| Rate for Payer: Mclaren Medicaid |
$169.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.79
|
| Rate for Payer: Meridian Medicaid |
$178.47
|
| Rate for Payer: Nomi Health Commercial |
$304.91
|
| Rate for Payer: PACE SWMI |
$254.09
|
| Rate for Payer: PHP Medicare Advantage |
$254.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.10
|
| Rate for Payer: Priority Health HMO/PPO |
$474.30
|
| Rate for Payer: Priority Health Medicare |
$256.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$474.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.09
|
| Rate for Payer: UHC Exchange |
$254.09
|
| Rate for Payer: UHC Medicare Advantage |
$254.09
|
| Rate for Payer: UHCCP Medicaid |
$169.97
|
|
|
PR EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 43240
|
| Min. Negotiated Rate |
$41.74 |
| Max. Negotiated Rate |
$772.20 |
| Rate for Payer: Aetna Commercial |
$492.68
|
| Rate for Payer: Aetna Medicare |
$382.38
|
| Rate for Payer: BCBS Complete |
$258.09
|
| Rate for Payer: BCBS MAPPO |
$367.67
|
| Rate for Payer: BCBS Trust/PPO |
$41.74
|
| Rate for Payer: BCN Commercial |
$560.02
|
| Rate for Payer: BCN Medicare Advantage |
$367.67
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$529.44
|
| Rate for Payer: Cofinity Commercial |
$492.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.67
|
| Rate for Payer: Mclaren Medicaid |
$245.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.05
|
| Rate for Payer: Meridian Medicaid |
$258.09
|
| Rate for Payer: Nomi Health Commercial |
$441.20
|
| Rate for Payer: PACE SWMI |
$367.67
|
| Rate for Payer: PHP Medicare Advantage |
$367.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.20
|
| Rate for Payer: Priority Health HMO/PPO |
$688.47
|
| Rate for Payer: Priority Health Medicare |
$371.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$688.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$367.67
|
| Rate for Payer: UHC Exchange |
$367.67
|
| Rate for Payer: UHC Medicare Advantage |
$367.67
|
| Rate for Payer: UHCCP Medicaid |
$245.80
|
|
|
PR EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 43253
|
| Min. Negotiated Rate |
$165.29 |
| Max. Negotiated Rate |
$1,676.30 |
| Rate for Payer: Aetna Commercial |
$331.02
|
| Rate for Payer: Aetna Medicare |
$256.91
|
| Rate for Payer: BCBS Complete |
$173.55
|
| Rate for Payer: BCBS MAPPO |
$247.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCN Commercial |
$376.28
|
| Rate for Payer: BCN Medicare Advantage |
$247.03
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$355.72
|
| Rate for Payer: Cofinity Commercial |
$331.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.03
|
| Rate for Payer: Mclaren Medicaid |
$165.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.38
|
| Rate for Payer: Meridian Medicaid |
$173.55
|
| Rate for Payer: Nomi Health Commercial |
$296.44
|
| Rate for Payer: PACE SWMI |
$247.03
|
| Rate for Payer: PHP Medicare Advantage |
$247.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health HMO/PPO |
$461.16
|
| Rate for Payer: Priority Health Medicare |
$249.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.03
|
| Rate for Payer: UHC Exchange |
$247.03
|
| Rate for Payer: UHC Medicare Advantage |
$247.03
|
| Rate for Payer: UHCCP Medicaid |
$165.29
|
|
|
PR EKG FOR INITIAL PREVENT EXAM
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS G0403
|
| Min. Negotiated Rate |
$13.33 |
| Max. Negotiated Rate |
$1,763.47 |
| Rate for Payer: Aetna Commercial |
$17.86
|
| Rate for Payer: Aetna Medicare |
$13.86
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$13.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,763.47
|
| Rate for Payer: BCN Commercial |
$21.02
|
| Rate for Payer: BCN Medicare Advantage |
$13.33
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.00
|
| Rate for Payer: Nomi Health Commercial |
$16.00
|
| Rate for Payer: PACE SWMI |
$13.33
|
| Rate for Payer: PHP Medicare Advantage |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO |
$20.24
|
| Rate for Payer: Priority Health Medicare |
$13.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.33
|
| Rate for Payer: UHC Exchange |
$13.33
|
| Rate for Payer: UHC Medicare Advantage |
$13.33
|
|
