|
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: Aetna New Business (MI Preferred) |
$4,576.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,917.66
|
| 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 |
$4,576.15
|
| Rate for Payer: Cofinity Commercial |
$4,917.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,415.04
|
| 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 Commercial |
$4,781.06
|
| 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/Tiered Network |
$6,270.21
|
| Rate for Payer: Priority Health Medicare |
$3,415.04
|
| Rate for Payer: Priority Health Narrow Network |
$6,270.21
|
| Rate for Payer: Priority Health SBD |
$6,270.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,415.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,415.04
|
| Rate for Payer: UHCCP Medicaid |
$2,242.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,000.58
|
|
|
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: Aetna New Business (MI Preferred) |
$4,109.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,415.95
|
| 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 |
$4,109.28
|
| Rate for Payer: Cofinity Commercial |
$4,415.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,066.63
|
| 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 Commercial |
$4,293.28
|
| 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/Tiered Network |
$5,610.97
|
| Rate for Payer: Priority Health Medicare |
$3,066.63
|
| Rate for Payer: Priority Health Narrow Network |
$5,610.97
|
| Rate for Payer: Priority Health SBD |
$5,610.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,066.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,066.63
|
| Rate for Payer: UHCCP Medicaid |
$2,018.39
|
| Rate for Payer: UMR Bronson Commercial |
$3,038.30
|
|
|
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: Aetna New Business (MI Preferred) |
$4,829.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,189.82
|
| 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 |
$4,829.41
|
| Rate for Payer: Cofinity Commercial |
$5,189.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,604.04
|
| 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 Commercial |
$5,045.66
|
| 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/Tiered Network |
$6,612.65
|
| Rate for Payer: Priority Health Medicare |
$3,604.04
|
| Rate for Payer: Priority Health Narrow Network |
$6,612.65
|
| Rate for Payer: Priority Health SBD |
$6,612.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,604.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,604.04
|
| Rate for Payer: UHCCP Medicaid |
$2,367.71
|
| Rate for Payer: UMR Bronson Commercial |
$2,984.02
|
|
|
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: Aetna New Business (MI Preferred) |
$174.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.43
|
| 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 |
$174.41
|
| Rate for Payer: Cofinity Commercial |
$187.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.16
|
| 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 Commercial |
$182.22
|
| 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/Tiered Network |
$244.61
|
| Rate for Payer: Priority Health Medicare |
$130.16
|
| Rate for Payer: Priority Health Narrow Network |
$244.61
|
| Rate for Payer: Priority Health SBD |
$244.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.16
|
| Rate for Payer: UHC Medicare Advantage |
$130.16
|
| Rate for Payer: UHCCP Medicaid |
$87.33
|
| Rate for Payer: UMR Bronson Commercial |
$310.50
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$469.95
|
| Rate for Payer: Aetna Commercial |
$614.55
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$693.15
|
| Rate for Payer: BCN Commercial |
$693.15
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$621.78
|
| Rate for Payer: Cofinity Commercial |
$506.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$506.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$650.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$506.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.25
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.55
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$614.55
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$455.49
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.26
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$116.60
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$267.51
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.25
|
|
|
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: Aetna New Business (MI Preferred) |
$155.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.84
|
| 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 |
$155.25
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| 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 Commercial |
$162.20
|
| 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/Tiered Network |
$216.56
|
| Rate for Payer: Priority Health Medicare |
$115.86
|
| Rate for Payer: Priority Health Narrow Network |
$216.56
|
| Rate for Payer: Priority Health SBD |
$216.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$77.75
|
| Rate for Payer: UMR Bronson Commercial |
$332.58
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$318.12 |
| Max. Negotiated Rate |
$650.70 |
| Rate for Payer: Aetna American Axle |
$469.95
|
| Rate for Payer: Aetna Commercial |
$614.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$469.95
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$506.10
|
| Rate for Payer: Cofinity Commercial |
$621.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$506.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.40
|
| Rate for Payer: Healthscope Commercial |
$650.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$506.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.55
|
| Rate for Payer: PHP Commercial |
$614.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health SBD |
$455.49
|
| Rate for Payer: UMR Bronson Commercial |
$318.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.25
|
|
|
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: Aetna New Business (MI Preferred) |
$155.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.84
|
| 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 |
$155.25
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| 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 Commercial |
$162.20
|
| 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/Tiered Network |
$216.56
|
| Rate for Payer: Priority Health Medicare |
$115.86
|
| Rate for Payer: Priority Health Narrow Network |
$216.56
|
| Rate for Payer: Priority Health SBD |
$216.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$77.75
|
| Rate for Payer: UMR Bronson Commercial |
$332.58
|
|
|
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: Aetna New Business (MI Preferred) |
$246.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.53
|
| 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 |
$246.16
|
| Rate for Payer: Cofinity Commercial |
$264.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.70
|
| 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 Commercial |
$257.18
|
| 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/Tiered Network |
$344.24
|
| Rate for Payer: Priority Health Medicare |
$183.70
|
| Rate for Payer: Priority Health Narrow Network |
$344.24
|
| Rate for Payer: Priority Health SBD |
$344.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.70
|
| Rate for Payer: UHC Medicare Advantage |
$183.70
|
| Rate for Payer: UHCCP Medicaid |
$123.11
|
| Rate for Payer: UMR Bronson Commercial |
$423.20
|
|
|
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: Aetna New Business (MI Preferred) |
$1,742.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,872.27
|
| 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 |
$1,742.25
|
| Rate for Payer: Cofinity Commercial |
$1,872.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,300.19
|
| 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 Commercial |
$1,820.27
|
| 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/Tiered Network |
$2,392.94
|
| Rate for Payer: Priority Health Medicare |
$1,300.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,392.94
|
| Rate for Payer: Priority Health SBD |
$2,392.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,300.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.19
|
| Rate for Payer: UHCCP Medicaid |
$859.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,088.82
|
|
|
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: Aetna New Business (MI Preferred) |
$1,730.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.34
|
| 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 |
$1,730.22
|
| Rate for Payer: Cofinity Commercial |
$1,859.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,291.21
|
| 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 Commercial |
$1,807.69
|
| 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/Tiered Network |
$2,372.65
|
| Rate for Payer: Priority Health Medicare |
$1,291.21
|
| Rate for Payer: Priority Health Narrow Network |
$2,372.65
|
| Rate for Payer: Priority Health SBD |
$2,372.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,291.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,291.21
|
| Rate for Payer: UHCCP Medicaid |
$850.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,467.86
|
|
|
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
|
| Rate for Payer: UMR Bronson Commercial |
$662.40
|
|
|
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: Aetna New Business (MI Preferred) |
$249.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.65
|
| 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: 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 Commercial |
$260.22
|
| 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/Tiered Network |
$343.04
|
| Rate for Payer: Priority Health Medicare |
$185.87
|
| Rate for Payer: Priority Health Narrow Network |
$343.04
|
| Rate for Payer: Priority Health SBD |
$343.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.87
|
| Rate for Payer: UHC Medicare Advantage |
$185.87
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
| Rate for Payer: UMR Bronson Commercial |
$185.38
|
|
|
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: Aetna New Business (MI Preferred) |
$150.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.50
|
| 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 |
$150.28
|
| Rate for Payer: Cofinity Commercial |
$161.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.15
|
| 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 Commercial |
$157.01
|
| 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/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Medicare |
$112.15
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: Priority Health SBD |
$208.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.15
|
| Rate for Payer: UHC Medicare Advantage |
$112.15
|
| Rate for Payer: UHCCP Medicaid |
$75.19
|
| Rate for Payer: UMR Bronson Commercial |
$698.28
|
|
|
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: Aetna New Business (MI Preferred) |
$167.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.84
|
| 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 |
$167.35
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.89
|
| 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 Commercial |
$174.85
|
| 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/Tiered Network |
$230.88
|
| Rate for Payer: Priority Health Medicare |
$124.89
|
| Rate for Payer: Priority Health Narrow Network |
$230.88
|
| Rate for Payer: Priority Health SBD |
$230.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.89
|
| Rate for Payer: UHC Medicare Advantage |
$124.89
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
| Rate for Payer: UMR Bronson Commercial |
$362.94
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$684.45 |
| Rate for Payer: Aetna Commercial |
$180.47
|
| Rate for Payer: Aetna Medicare |
$140.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS MAPPO |
$134.68
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: BCN Medicare Advantage |
$134.68
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$180.47
|
| Rate for Payer: Cofinity Commercial |
$193.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.41
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Nomi Health Commercial |
$161.62
|
| Rate for Payer: PACE SWMI |
$134.68
|
| Rate for Payer: PHP Commercial |
$188.55
|
| Rate for Payer: PHP Medicare Advantage |
$134.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Medicare |
$134.68
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: Priority Health SBD |
$249.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.68
|
| Rate for Payer: UHC Medicare Advantage |
$134.68
|
| Rate for Payer: UHCCP Medicaid |
$89.89
|
| Rate for Payer: UMR Bronson Commercial |
$484.38
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
IP
|
$1,053.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$463.32 |
| Max. Negotiated Rate |
$947.70 |
| Rate for Payer: Aetna American Axle |
$684.45
|
| Rate for Payer: Aetna Commercial |
$895.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.45
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$737.10
|
| Rate for Payer: Cofinity Commercial |
$905.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Healthscope Commercial |
$947.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: PHP Commercial |
$895.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health SBD |
$663.39
|
| Rate for Payer: UMR Bronson Commercial |
$463.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.75
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$1,053.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$135.36 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna American Axle |
$684.45
|
| Rate for Payer: Aetna Commercial |
$895.05
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$868.11
|
| Rate for Payer: BCN Commercial |
$868.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$737.10
|
| Rate for Payer: Cofinity Commercial |
$905.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$947.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.75
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$3,903.12
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$895.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,841.66
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$4,673.33
|
| Rate for Payer: Priority Health SBD |
$663.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.90
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$135.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: UMR Bronson Commercial |
$389.61
|
| Rate for Payer: VA VA |
$1,858.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.75
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 43215
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$684.45 |
| Rate for Payer: Aetna Commercial |
$180.47
|
| Rate for Payer: Aetna Medicare |
$140.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.94
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS MAPPO |
$134.68
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: BCN Medicare Advantage |
$134.68
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$180.47
|
| Rate for Payer: Cofinity Commercial |
$193.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.41
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Nomi Health Commercial |
$161.62
|
| Rate for Payer: PACE SWMI |
$134.68
|
| Rate for Payer: PHP Commercial |
$188.55
|
| Rate for Payer: PHP Medicare Advantage |
$134.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Medicare |
$134.68
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: Priority Health SBD |
$249.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.68
|
| Rate for Payer: UHC Medicare Advantage |
$134.68
|
| Rate for Payer: UHCCP Medicaid |
$89.89
|
| Rate for Payer: UMR Bronson Commercial |
$484.38
|
|
|
PR ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43217
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Aetna Commercial |
$202.22
|
| Rate for Payer: Aetna Medicare |
$156.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.31
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$150.91
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: BCN Medicare Advantage |
$150.91
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$202.22
|
| Rate for Payer: Cofinity Commercial |
$217.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.46
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Nomi Health Commercial |
$181.09
|
| Rate for Payer: PACE SWMI |
$150.91
|
| Rate for Payer: PHP Commercial |
$211.27
|
| Rate for Payer: PHP Medicare Advantage |
$150.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.19
|
| Rate for Payer: Priority Health Medicare |
$150.91
|
| Rate for Payer: Priority Health Narrow Network |
$282.19
|
| Rate for Payer: Priority Health SBD |
$282.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.91
|
| Rate for Payer: UHC Medicare Advantage |
$150.91
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
| Rate for Payer: UMR Bronson Commercial |
$538.20
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 43200
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$388.99 |
| Rate for Payer: Aetna Commercial |
$111.31
|
| Rate for Payer: Aetna Medicare |
$86.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.62
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$83.07
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$388.99
|
| Rate for Payer: BCN Medicare Advantage |
$83.07
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cofinity Commercial |
$111.31
|
| Rate for Payer: Cofinity Commercial |
$119.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.22
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Nomi Health Commercial |
$99.68
|
| Rate for Payer: PACE SWMI |
$83.07
|
| Rate for Payer: PHP Commercial |
$116.30
|
| Rate for Payer: PHP Medicare Advantage |
$83.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.30
|
| Rate for Payer: Priority Health Medicare |
$83.07
|
| Rate for Payer: Priority Health Narrow Network |
$156.30
|
| Rate for Payer: Priority Health SBD |
$156.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.07
|
| Rate for Payer: UHC Medicare Advantage |
$83.07
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
| Rate for Payer: UMR Bronson Commercial |
$185.38
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43231
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Aetna Commercial |
$196.12
|
| Rate for Payer: Aetna Medicare |
$152.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.76
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS MAPPO |
$146.36
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$146.36
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cofinity Commercial |
$196.12
|
| Rate for Payer: Cofinity Commercial |
$210.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.68
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Nomi Health Commercial |
$175.63
|
| Rate for Payer: PACE SWMI |
$146.36
|
| Rate for Payer: PHP Commercial |
$204.90
|
| Rate for Payer: PHP Medicare Advantage |
$146.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.81
|
| Rate for Payer: Priority Health Medicare |
$146.36
|
| Rate for Payer: Priority Health Narrow Network |
$276.81
|
| Rate for Payer: Priority Health SBD |
$276.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.36
|
| Rate for Payer: UHC Medicare Advantage |
$146.36
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
| Rate for Payer: UMR Bronson Commercial |
$406.64
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$347.16 |
| Max. Negotiated Rate |
$710.10 |
| Rate for Payer: Aetna American Axle |
$512.85
|
| Rate for Payer: Aetna Commercial |
$670.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.85
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$552.30
|
| Rate for Payer: Cofinity Commercial |
$678.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.20
|
| Rate for Payer: Healthscope Commercial |
$710.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.65
|
| Rate for Payer: PHP Commercial |
$670.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health SBD |
$497.07
|
| Rate for Payer: UMR Bronson Commercial |
$347.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.75
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$526.80 |
| Rate for Payer: Aetna Commercial |
$129.97
|
| Rate for Payer: Aetna Medicare |
$100.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.67
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS MAPPO |
$96.99
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: BCN Medicare Advantage |
$96.99
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$139.67
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.84
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Nomi Health Commercial |
$116.39
|
| Rate for Payer: PACE SWMI |
$96.99
|
| Rate for Payer: PHP Commercial |
$135.79
|
| Rate for Payer: PHP Medicare Advantage |
$96.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.56
|
| Rate for Payer: Priority Health Medicare |
$96.99
|
| Rate for Payer: Priority Health Narrow Network |
$182.56
|
| Rate for Payer: Priority Health SBD |
$182.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.99
|
| Rate for Payer: UHC Medicare Advantage |
$96.99
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
| Rate for Payer: UMR Bronson Commercial |
$362.94
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$98.27 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna American Axle |
$512.85
|
| Rate for Payer: Aetna Commercial |
$670.65
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$947.27
|
| Rate for Payer: BCN Commercial |
$947.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$678.54
|
| Rate for Payer: Cofinity Commercial |
$552.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$710.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.75
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.65
|
| Rate for Payer: Nomi Health Commercial |
$3,903.12
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$670.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,841.66
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$4,673.33
|
| Rate for Payer: Priority Health SBD |
$497.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.10
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$98.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: UMR Bronson Commercial |
$291.93
|
| Rate for Payer: VA VA |
$1,858.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.75
|
|
