|
PR ERCP W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43261
|
| Min. Negotiated Rate |
$212.36 |
| Max. Negotiated Rate |
$1,040.08 |
| Rate for Payer: Aetna Commercial |
$425.58
|
| Rate for Payer: Aetna Medicare |
$330.30
|
| Rate for Payer: BCBS Complete |
$222.98
|
| Rate for Payer: BCBS MAPPO |
$317.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.08
|
| Rate for Payer: BCN Commercial |
$484.28
|
| Rate for Payer: BCN Medicare Advantage |
$317.60
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$457.34
|
| Rate for Payer: Cofinity Commercial |
$425.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.60
|
| Rate for Payer: Mclaren Medicaid |
$212.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.48
|
| Rate for Payer: Meridian Medicaid |
$222.98
|
| Rate for Payer: Nomi Health Commercial |
$381.12
|
| Rate for Payer: PACE SWMI |
$317.60
|
| Rate for Payer: PHP Medicare Advantage |
$317.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$212.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO |
$594.81
|
| Rate for Payer: Priority Health Medicare |
$320.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$594.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$317.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.60
|
| Rate for Payer: UHC Exchange |
$317.60
|
| Rate for Payer: UHC Medicare Advantage |
$317.60
|
| Rate for Payer: UHCCP Medicaid |
$212.36
|
|
|
PR ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI
|
Professional
|
Both
|
$1,622.00
|
|
|
Service Code
|
HCPCS 43263
|
| Min. Negotiated Rate |
$224.50 |
| Max. Negotiated Rate |
$1,054.30 |
| Rate for Payer: Aetna Commercial |
$450.01
|
| Rate for Payer: Aetna Medicare |
$349.26
|
| Rate for Payer: BCBS Complete |
$235.72
|
| Rate for Payer: BCBS MAPPO |
$335.83
|
| Rate for Payer: BCBS Trust/PPO |
$935.09
|
| Rate for Payer: BCN Commercial |
$511.16
|
| Rate for Payer: BCN Medicare Advantage |
$335.83
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cash Price |
$1,297.60
|
| Rate for Payer: Cofinity Commercial |
$483.60
|
| Rate for Payer: Cofinity Commercial |
$450.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.83
|
| Rate for Payer: Mclaren Medicaid |
$224.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.62
|
| Rate for Payer: Meridian Medicaid |
$235.72
|
| Rate for Payer: Nomi Health Commercial |
$403.00
|
| Rate for Payer: PACE SWMI |
$335.83
|
| Rate for Payer: PHP Medicare Advantage |
$335.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,054.30
|
| Rate for Payer: Priority Health HMO/PPO |
$627.61
|
| Rate for Payer: Priority Health Medicare |
$339.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$627.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.83
|
| Rate for Payer: UHC Exchange |
$335.83
|
| Rate for Payer: UHC Medicare Advantage |
$335.83
|
| Rate for Payer: UHCCP Medicaid |
$224.50
|
|
|
PR ERCP W/SPHINCTEROTOMY/PAPILLOTOMY
|
Professional
|
Both
|
$1,688.00
|
|
|
Service Code
|
HCPCS 43262
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$1,187.83 |
| Rate for Payer: Aetna Commercial |
$449.10
|
| Rate for Payer: Aetna Medicare |
$348.56
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$335.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.83
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$335.15
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cash Price |
$1,350.40
|
| Rate for Payer: Cofinity Commercial |
$482.62
|
| Rate for Payer: Cofinity Commercial |
$449.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.15
|
| Rate for Payer: Mclaren Medicaid |
$224.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.91
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Nomi Health Commercial |
$402.18
|
| Rate for Payer: PACE SWMI |
$335.15
|
| Rate for Payer: PHP Medicare Advantage |
$335.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,097.20
|
| Rate for Payer: Priority Health HMO/PPO |
$626.43
|
| Rate for Payer: Priority Health Medicare |
$338.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.15
|
| Rate for Payer: UHC Exchange |
$335.15
|
| Rate for Payer: UHC Medicare Advantage |
$335.15
|
| Rate for Payer: UHCCP Medicaid |
$224.08
|
|
|
PR ESCHAROTOMY EACH ADDITIONAL INCISION
|
Professional
|
Both
|
$434.00
|
|
|
Service Code
|
HCPCS 16036
|
| Min. Negotiated Rate |
$52.61 |
| Max. Negotiated Rate |
$282.10 |
| Rate for Payer: Aetna Commercial |
$107.17
|
| Rate for Payer: Aetna Medicare |
$83.18
|
| Rate for Payer: BCBS Complete |
$55.24
|
| Rate for Payer: BCBS MAPPO |
$79.98
|
| Rate for Payer: BCBS Trust/PPO |
$119.96
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$79.98
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cash Price |
$347.20
|
| Rate for Payer: Cofinity Commercial |
$115.17
|
| Rate for Payer: Cofinity Commercial |
$107.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.98
|
| Rate for Payer: Mclaren Medicaid |
$52.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.98
|
| Rate for Payer: Meridian Medicaid |
$55.24
|
| Rate for Payer: Nomi Health Commercial |
$95.98
|
| Rate for Payer: PACE SWMI |
$79.98
|
| Rate for Payer: PHP Medicare Advantage |
$79.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.10
|
| Rate for Payer: Priority Health HMO/PPO |
$110.62
|
| Rate for Payer: Priority Health Medicare |
$80.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.98
|
| Rate for Payer: UHC Exchange |
$79.98
|
| Rate for Payer: UHC Medicare Advantage |
$79.98
|
| Rate for Payer: UHCCP Medicaid |
$52.61
|
|
|
PR ESCHAROTOMY FIRST INCISION
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 16035
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$559.00 |
| Rate for Payer: Aetna Commercial |
$252.01
|
| Rate for Payer: Aetna Medicare |
$195.59
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$188.07
|
| Rate for Payer: BCBS Trust/PPO |
$23.70
|
| Rate for Payer: BCN Commercial |
$281.48
|
| Rate for Payer: BCN Medicare Advantage |
$188.07
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$270.82
|
| Rate for Payer: Cofinity Commercial |
$252.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.07
|
| Rate for Payer: Mclaren Medicaid |
$124.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.47
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Nomi Health Commercial |
$225.68
|
| Rate for Payer: PACE SWMI |
$188.07
|
| Rate for Payer: PHP Medicare Advantage |
$188.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.00
|
| Rate for Payer: Priority Health HMO/PPO |
$263.24
|
| Rate for Payer: Priority Health Medicare |
$189.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.07
|
| Rate for Payer: UHC Exchange |
$188.07
|
| Rate for Payer: UHC Medicare Advantage |
$188.07
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
|
|
PR ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH
|
Professional
|
Both
|
$3,466.00
|
|
|
Service Code
|
HCPCS 43325
|
| Min. Negotiated Rate |
$873.30 |
| Max. Negotiated Rate |
$2,431.72 |
| Rate for Payer: Aetna Commercial |
$1,771.44
|
| Rate for Payer: Aetna Medicare |
$1,374.85
|
| Rate for Payer: BCBS Complete |
$916.96
|
| Rate for Payer: BCBS MAPPO |
$1,321.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,668.90
|
| Rate for Payer: BCN Commercial |
$1,983.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,321.97
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cash Price |
$2,772.80
|
| Rate for Payer: Cofinity Commercial |
$1,903.64
|
| Rate for Payer: Cofinity Commercial |
$1,771.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,321.97
|
| Rate for Payer: Mclaren Medicaid |
$873.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,388.07
|
| Rate for Payer: Meridian Medicaid |
$916.96
|
| Rate for Payer: Nomi Health Commercial |
$1,586.36
|
| Rate for Payer: PACE SWMI |
$1,321.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,321.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$873.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,252.90
|
| Rate for Payer: Priority Health HMO/PPO |
$2,431.72
|
| Rate for Payer: Priority Health Medicare |
$1,335.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,431.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,321.97
|
| Rate for Payer: UHC Exchange |
$1,321.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,321.97
|
| Rate for Payer: UHCCP Medicaid |
$873.30
|
|
|
PR ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY
|
Professional
|
Both
|
$2,096.00
|
|
|
Service Code
|
HCPCS 43327
|
| Min. Negotiated Rate |
$537.19 |
| Max. Negotiated Rate |
$2,023.92 |
| Rate for Payer: Aetna Commercial |
$1,086.08
|
| Rate for Payer: Aetna Medicare |
$842.93
|
| Rate for Payer: BCBS Complete |
$564.05
|
| Rate for Payer: BCBS MAPPO |
$810.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,023.92
|
| Rate for Payer: BCN Commercial |
$1,197.26
|
| Rate for Payer: BCN Medicare Advantage |
$810.51
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cofinity Commercial |
$1,167.13
|
| Rate for Payer: Cofinity Commercial |
$1,086.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.51
|
| Rate for Payer: Mclaren Medicaid |
$537.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$851.04
|
| Rate for Payer: Meridian Medicaid |
$564.05
|
| Rate for Payer: Nomi Health Commercial |
$972.61
|
| Rate for Payer: PACE SWMI |
$810.51
|
| Rate for Payer: PHP Medicare Advantage |
$810.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$537.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,461.65
|
| Rate for Payer: Priority Health Medicare |
$818.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,461.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.51
|
| Rate for Payer: UHC Exchange |
$810.51
|
| Rate for Payer: UHC Medicare Advantage |
$810.51
|
| Rate for Payer: UHCCP Medicaid |
$537.19
|
|
|
PR ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 43460
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$1,198.18 |
| Rate for Payer: Aetna Commercial |
$268.72
|
| Rate for Payer: Aetna Medicare |
$208.56
|
| Rate for Payer: BCBS Complete |
$140.90
|
| Rate for Payer: BCBS MAPPO |
$200.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.18
|
| Rate for Payer: BCN Commercial |
$304.45
|
| Rate for Payer: BCN Medicare Advantage |
$200.54
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cofinity Commercial |
$288.78
|
| Rate for Payer: Cofinity Commercial |
$268.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.54
|
| Rate for Payer: Mclaren Medicaid |
$134.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.57
|
| Rate for Payer: Meridian Medicaid |
$140.90
|
| Rate for Payer: Nomi Health Commercial |
$240.65
|
| Rate for Payer: PACE SWMI |
$200.54
|
| Rate for Payer: PHP Medicare Advantage |
$200.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.90
|
| Rate for Payer: Priority Health HMO/PPO |
$373.47
|
| Rate for Payer: Priority Health Medicare |
$202.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.54
|
| Rate for Payer: UHC Exchange |
$200.54
|
| Rate for Payer: UHC Medicare Advantage |
$200.54
|
| Rate for Payer: UHCCP Medicaid |
$134.19
|
|
|
PR ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 91013
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$1,265.81 |
| Rate for Payer: Aetna Commercial |
$30.42
|
| Rate for Payer: Aetna Medicare |
$23.61
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$22.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,265.81
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: BCN Medicare Advantage |
$22.70
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.70
|
| Rate for Payer: Mclaren Medicaid |
$5.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.84
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Nomi Health Commercial |
$27.24
|
| Rate for Payer: PACE SWMI |
$22.70
|
| Rate for Payer: PHP Medicare Advantage |
$22.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO |
$12.22
|
| Rate for Payer: Priority Health Medicare |
$22.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.70
|
| Rate for Payer: UHC Exchange |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$22.70
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
|
|
PR ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT
|
Professional
|
Both
|
$384.00
|
|
|
Service Code
|
HCPCS 91010
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$323.99 |
| Rate for Payer: Aetna Commercial |
$261.21
|
| Rate for Payer: Aetna Commercial |
$261.21
|
| Rate for Payer: Aetna Medicare |
$202.73
|
| Rate for Payer: Aetna Medicare |
$202.73
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$194.93
|
| Rate for Payer: BCBS MAPPO |
$194.93
|
| 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 |
$194.93
|
| Rate for Payer: BCN Medicare Advantage |
$194.93
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cofinity Commercial |
$280.70
|
| Rate for Payer: Cofinity Commercial |
$261.21
|
| Rate for Payer: Cofinity Commercial |
$280.70
|
| Rate for Payer: Cofinity Commercial |
$261.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.93
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.68
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Nomi Health Commercial |
$233.92
|
| Rate for Payer: Nomi Health Commercial |
$233.92
|
| Rate for Payer: PACE SWMI |
$194.93
|
| Rate for Payer: PACE SWMI |
$194.93
|
| Rate for Payer: PHP Medicare Advantage |
$194.93
|
| Rate for Payer: PHP Medicare Advantage |
$194.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health HMO/PPO |
$85.94
|
| Rate for Payer: Priority Health HMO/PPO |
$85.94
|
| Rate for Payer: Priority Health Medicare |
$196.88
|
| Rate for Payer: Priority Health Medicare |
$196.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.93
|
| Rate for Payer: UHC Exchange |
$194.93
|
| Rate for Payer: UHC Exchange |
$194.93
|
| Rate for Payer: UHC Medicare Advantage |
$194.93
|
| Rate for Payer: UHC Medicare Advantage |
$194.93
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
PR ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ
|
Professional
|
Both
|
$6,523.00
|
|
|
Service Code
|
HCPCS 43287
|
| Min. Negotiated Rate |
$994.79 |
| Max. Negotiated Rate |
$6,270.21 |
| Rate for Payer: Aetna Commercial |
$4,576.15
|
| Rate for Payer: Aetna Medicare |
$3,551.64
|
| Rate for Payer: BCBS Complete |
$2,354.81
|
| Rate for Payer: BCBS MAPPO |
$3,415.04
|
| Rate for Payer: BCBS Trust/PPO |
$994.79
|
| Rate for Payer: BCN Commercial |
$5,110.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,415.04
|
| Rate for Payer: Cash Price |
$5,218.40
|
| Rate for Payer: Cash Price |
$5,218.40
|
| Rate for Payer: Cofinity Commercial |
$4,917.66
|
| Rate for Payer: Cofinity Commercial |
$4,576.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,415.04
|
| Rate for Payer: Mclaren Medicaid |
$2,242.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,585.79
|
| Rate for Payer: Meridian Medicaid |
$2,354.81
|
| Rate for Payer: Nomi Health Commercial |
$4,098.05
|
| Rate for Payer: PACE SWMI |
$3,415.04
|
| Rate for Payer: PHP Medicare Advantage |
$3,415.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,242.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,239.95
|
| Rate for Payer: Priority Health HMO/PPO |
$6,270.21
|
| Rate for Payer: Priority Health Medicare |
$3,449.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,270.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,415.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,415.04
|
| Rate for Payer: UHC Exchange |
$3,415.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,415.04
|
| Rate for Payer: UHCCP Medicaid |
$2,242.68
|
|
|
PR ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ
|
Professional
|
Both
|
$6,605.00
|
|
|
Service Code
|
HCPCS 43286
|
| Min. Negotiated Rate |
$817.81 |
| Max. Negotiated Rate |
$5,610.97 |
| Rate for Payer: Aetna Commercial |
$4,109.28
|
| Rate for Payer: Aetna Medicare |
$3,189.30
|
| Rate for Payer: BCBS Complete |
$2,119.31
|
| Rate for Payer: BCBS MAPPO |
$3,066.63
|
| Rate for Payer: BCBS Trust/PPO |
$817.81
|
| Rate for Payer: BCN Commercial |
$4,596.01
|
| Rate for Payer: BCN Medicare Advantage |
$3,066.63
|
| Rate for Payer: Cash Price |
$5,284.00
|
| Rate for Payer: Cash Price |
$5,284.00
|
| Rate for Payer: Cofinity Commercial |
$4,415.95
|
| Rate for Payer: Cofinity Commercial |
$4,109.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,066.63
|
| Rate for Payer: Mclaren Medicaid |
$2,018.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,219.96
|
| Rate for Payer: Meridian Medicaid |
$2,119.31
|
| Rate for Payer: Nomi Health Commercial |
$3,679.96
|
| Rate for Payer: PACE SWMI |
$3,066.63
|
| Rate for Payer: PHP Medicare Advantage |
$3,066.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,018.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,293.25
|
| Rate for Payer: Priority Health HMO/PPO |
$5,610.97
|
| Rate for Payer: Priority Health Medicare |
$3,097.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,610.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,066.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,066.63
|
| Rate for Payer: UHC Exchange |
$3,066.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,066.63
|
| Rate for Payer: UHCCP Medicaid |
$2,018.39
|
|
|
PR ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ
|
Professional
|
Both
|
$6,487.00
|
|
|
Service Code
|
HCPCS 43288
|
| Min. Negotiated Rate |
$1,474.49 |
| Max. Negotiated Rate |
$6,612.65 |
| Rate for Payer: Aetna Commercial |
$4,829.41
|
| Rate for Payer: Aetna Medicare |
$3,748.20
|
| Rate for Payer: BCBS Complete |
$2,486.10
|
| Rate for Payer: BCBS MAPPO |
$3,604.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,474.49
|
| Rate for Payer: BCN Commercial |
$5,396.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,604.04
|
| Rate for Payer: Cash Price |
$5,189.60
|
| Rate for Payer: Cash Price |
$5,189.60
|
| Rate for Payer: Cofinity Commercial |
$5,189.82
|
| Rate for Payer: Cofinity Commercial |
$4,829.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,604.04
|
| Rate for Payer: Mclaren Medicaid |
$2,367.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,784.24
|
| Rate for Payer: Meridian Medicaid |
$2,486.10
|
| Rate for Payer: Nomi Health Commercial |
$4,324.85
|
| Rate for Payer: PACE SWMI |
$3,604.04
|
| Rate for Payer: PHP Medicare Advantage |
$3,604.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,367.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,216.55
|
| Rate for Payer: Priority Health HMO/PPO |
$6,612.65
|
| Rate for Payer: Priority Health Medicare |
$3,640.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,612.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,604.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,604.04
|
| Rate for Payer: UHC Exchange |
$3,604.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,604.04
|
| Rate for Payer: UHCCP Medicaid |
$2,367.71
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 43236
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$590.33 |
| 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 |
$28.53
|
| Rate for Payer: BCN Commercial |
$590.33
|
| Rate for Payer: BCN Medicare Advantage |
$130.16
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| 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 |
$438.75
|
| 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 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 43235
|
| Hospital Charge Code |
43235
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$469.95 |
| Rate for Payer: Aetna Commercial |
$155.25
|
| Rate for Payer: Aetna Medicare |
$120.49
|
| Rate for Payer: BCBS Complete |
$81.64
|
| Rate for Payer: BCBS MAPPO |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$423.20
|
| Rate for Payer: BCN Medicare Advantage |
$115.86
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Cofinity Commercial |
$155.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| Rate for Payer: Mclaren Medicaid |
$77.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.65
|
| Rate for Payer: Meridian Medicaid |
$81.64
|
| Rate for Payer: Nomi Health Commercial |
$139.03
|
| Rate for Payer: PACE SWMI |
$115.86
|
| Rate for Payer: PHP Medicare Advantage |
$115.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO |
$216.56
|
| Rate for Payer: Priority Health Medicare |
$117.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Exchange |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$77.75
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 43235
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$469.95 |
| Rate for Payer: Aetna Commercial |
$155.25
|
| Rate for Payer: Aetna Medicare |
$120.49
|
| Rate for Payer: BCBS Complete |
$81.64
|
| Rate for Payer: BCBS MAPPO |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$423.20
|
| Rate for Payer: BCN Medicare Advantage |
$115.86
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Cofinity Commercial |
$155.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| Rate for Payer: Mclaren Medicaid |
$77.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.65
|
| Rate for Payer: Meridian Medicaid |
$81.64
|
| Rate for Payer: Nomi Health Commercial |
$139.03
|
| Rate for Payer: PACE SWMI |
$115.86
|
| Rate for Payer: PHP Medicare Advantage |
$115.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO |
$216.56
|
| Rate for Payer: Priority Health Medicare |
$117.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Exchange |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$77.75
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$469.95 |
| Max. Negotiated Rate |
$650.70 |
| Rate for Payer: Aetna Commercial |
$614.55
|
| Rate for Payer: BCBS Trust/PPO |
$590.18
|
| Rate for Payer: BCN Commercial |
$558.73
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$621.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.40
|
| Rate for Payer: Healthscope Commercial |
$650.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.55
|
| Rate for Payer: Nomi Health Commercial |
$592.86
|
| Rate for Payer: PHP Commercial |
$614.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO |
$629.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$484.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$636.24
|
| Rate for Payer: UHC Core |
$603.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.25
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$171.71 |
| Max. Negotiated Rate |
$697.40 |
| Rate for Payer: Aetna Commercial |
$614.55
|
| Rate for Payer: Aetna Medicare |
$187.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.94
|
| Rate for Payer: BCBS Complete |
$697.40
|
| Rate for Payer: BCBS MAPPO |
$180.75
|
| Rate for Payer: BCBS Trust/PPO |
$594.38
|
| Rate for Payer: BCN Commercial |
$562.13
|
| Rate for Payer: BCN Medicare Advantage |
$180.75
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$621.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.75
|
| Rate for Payer: Healthscope Commercial |
$650.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.25
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.79
|
| Rate for Payer: Meridian Medicaid |
$697.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.55
|
| Rate for Payer: Nomi Health Commercial |
$592.86
|
| Rate for Payer: PACE Senior Care Partners |
$171.71
|
| Rate for Payer: PACE SWMI |
$180.75
|
| Rate for Payer: PHP Commercial |
$614.55
|
| Rate for Payer: PHP Medicare Advantage |
$180.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO |
$629.01
|
| Rate for Payer: Priority Health Medicare |
$182.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$484.41
|
| Rate for Payer: Railroad Medicare Medicare |
$180.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$636.24
|
| Rate for Payer: UHC Core |
$603.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.75
|
| Rate for Payer: UHC Exchange |
$180.75
|
| Rate for Payer: UHC Medicare Advantage |
$180.75
|
| Rate for Payer: UHCCP Medicaid |
$664.15
|
| Rate for Payer: VA VA |
$180.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.25
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 43237
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$598.00 |
| Rate for Payer: Aetna Commercial |
$246.16
|
| Rate for Payer: Aetna Medicare |
$191.05
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCBS MAPPO |
$183.70
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$280.50
|
| Rate for Payer: BCN Medicare Advantage |
$183.70
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$264.53
|
| Rate for Payer: Cofinity Commercial |
$246.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.70
|
| Rate for Payer: Mclaren Medicaid |
$123.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.88
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Nomi Health Commercial |
$220.44
|
| Rate for Payer: PACE SWMI |
$183.70
|
| Rate for Payer: PHP Medicare Advantage |
$183.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.00
|
| Rate for Payer: Priority Health HMO/PPO |
$344.24
|
| Rate for Payer: Priority Health Medicare |
$185.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.70
|
| Rate for Payer: UHC Exchange |
$183.70
|
| Rate for Payer: UHC Medicare Advantage |
$183.70
|
| Rate for Payer: UHCCP Medicaid |
$123.11
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,367.00
|
|
|
Service Code
|
HCPCS 43330
|
| Min. Negotiated Rate |
$859.03 |
| Max. Negotiated Rate |
$2,635.16 |
| Rate for Payer: Aetna Commercial |
$1,742.25
|
| Rate for Payer: Aetna Medicare |
$1,352.20
|
| Rate for Payer: BCBS Complete |
$901.98
|
| Rate for Payer: BCBS MAPPO |
$1,300.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.16
|
| Rate for Payer: BCN Commercial |
$1,950.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,300.19
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cofinity Commercial |
$1,872.27
|
| Rate for Payer: Cofinity Commercial |
$1,742.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,300.19
|
| Rate for Payer: Mclaren Medicaid |
$859.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,365.20
|
| Rate for Payer: Meridian Medicaid |
$901.98
|
| Rate for Payer: Nomi Health Commercial |
$1,560.23
|
| Rate for Payer: PACE SWMI |
$1,300.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,300.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,392.94
|
| Rate for Payer: Priority Health Medicare |
$1,313.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,392.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,300.19
|
| Rate for Payer: UHC Exchange |
$1,300.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.19
|
| Rate for Payer: UHCCP Medicaid |
$859.03
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 43331
|
| Min. Negotiated Rate |
$648.75 |
| Max. Negotiated Rate |
$2,372.65 |
| Rate for Payer: Aetna Commercial |
$1,730.22
|
| Rate for Payer: Aetna Medicare |
$1,342.86
|
| Rate for Payer: BCBS Complete |
$893.26
|
| Rate for Payer: BCBS MAPPO |
$1,291.21
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: BCN Commercial |
$1,933.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,291.21
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cofinity Commercial |
$1,859.34
|
| Rate for Payer: Cofinity Commercial |
$1,730.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.21
|
| Rate for Payer: Mclaren Medicaid |
$850.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,355.77
|
| Rate for Payer: Meridian Medicaid |
$893.26
|
| Rate for Payer: Nomi Health Commercial |
$1,549.45
|
| Rate for Payer: PACE SWMI |
$1,291.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,291.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,372.65
|
| Rate for Payer: Priority Health Medicare |
$1,304.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,372.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,291.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,291.21
|
| Rate for Payer: UHC Exchange |
$1,291.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,291.21
|
| Rate for Payer: UHCCP Medicaid |
$850.72
|
|
|
PR ESOPHAGOSCOPY,ABLATION TUMOR
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 43228
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Medicare |
$720.00
|
| Rate for Payer: BCBS Complete |
$576.00
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$936.00
|
|
|
PR ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 43214
|
| Min. Negotiated Rate |
$123.97 |
| Max. Negotiated Rate |
$343.04 |
| Rate for Payer: Aetna Commercial |
$249.07
|
| Rate for Payer: Aetna Medicare |
$193.30
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$185.87
|
| Rate for Payer: BCBS Trust/PPO |
$167.47
|
| Rate for Payer: BCN Commercial |
$280.02
|
| Rate for Payer: BCN Medicare Advantage |
$185.87
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cofinity Commercial |
$267.65
|
| Rate for Payer: Cofinity Commercial |
$249.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.87
|
| Rate for Payer: Mclaren Medicaid |
$123.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.16
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$223.04
|
| Rate for Payer: PACE SWMI |
$185.87
|
| Rate for Payer: PHP Medicare Advantage |
$185.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO |
$343.04
|
| Rate for Payer: Priority Health Medicare |
$187.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.87
|
| Rate for Payer: UHC Exchange |
$185.87
|
| Rate for Payer: UHC Medicare Advantage |
$185.87
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 43220
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$1,333.11 |
| Rate for Payer: Aetna Commercial |
$150.28
|
| Rate for Payer: Aetna Medicare |
$116.64
|
| Rate for Payer: BCBS Complete |
$78.95
|
| Rate for Payer: BCBS MAPPO |
$112.15
|
| Rate for Payer: BCBS Trust/PPO |
$68.34
|
| Rate for Payer: BCN Commercial |
$1,333.11
|
| Rate for Payer: BCN Medicare Advantage |
$112.15
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cofinity Commercial |
$161.50
|
| Rate for Payer: Cofinity Commercial |
$150.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.15
|
| Rate for Payer: Mclaren Medicaid |
$75.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.76
|
| Rate for Payer: Meridian Medicaid |
$78.95
|
| Rate for Payer: Nomi Health Commercial |
$134.58
|
| Rate for Payer: PACE SWMI |
$112.15
|
| Rate for Payer: PHP Medicare Advantage |
$112.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.70
|
| Rate for Payer: Priority Health HMO/PPO |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$113.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.15
|
| Rate for Payer: UHC Exchange |
$112.15
|
| Rate for Payer: UHC Medicare Advantage |
$112.15
|
| Rate for Payer: UHCCP Medicaid |
$75.19
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43226
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$569.31 |
| Rate for Payer: Aetna Commercial |
$167.35
|
| Rate for Payer: Aetna Medicare |
$129.89
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$124.89
|
| Rate for Payer: BCBS Trust/PPO |
$127.32
|
| Rate for Payer: BCN Commercial |
$569.31
|
| Rate for Payer: BCN Medicare Advantage |
$124.89
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Cofinity Commercial |
$167.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.89
|
| Rate for Payer: Mclaren Medicaid |
$83.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.13
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Nomi Health Commercial |
$149.87
|
| Rate for Payer: PACE SWMI |
$124.89
|
| Rate for Payer: PHP Medicare Advantage |
$124.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO |
$230.88
|
| Rate for Payer: Priority Health Medicare |
$126.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.89
|
| Rate for Payer: UHC Exchange |
$124.89
|
| Rate for Payer: UHC Medicare Advantage |
$124.89
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
