|
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 W SUBMUCOUS INJ
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 43201
|
| Min. Negotiated Rate |
$30.11 |
| Max. Negotiated Rate |
$383.13 |
| Rate for Payer: Aetna Commercial |
$131.27
|
| Rate for Payer: Aetna Medicare |
$101.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.06
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$97.96
|
| Rate for Payer: BCBS Trust/PPO |
$30.11
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: BCN Medicare Advantage |
$97.96
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$131.27
|
| Rate for Payer: Cofinity Commercial |
$141.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.86
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: Nomi Health Commercial |
$117.55
|
| Rate for Payer: PACE SWMI |
$97.96
|
| Rate for Payer: PHP Commercial |
$137.14
|
| Rate for Payer: PHP Medicare Advantage |
$97.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.76
|
| Rate for Payer: Priority Health Medicare |
$97.96
|
| Rate for Payer: Priority Health Narrow Network |
$183.76
|
| Rate for Payer: Priority Health SBD |
$183.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.96
|
| Rate for Payer: UHC Medicare Advantage |
$97.96
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
| Rate for Payer: UMR Bronson Commercial |
$227.70
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43227
|
| Min. Negotiated Rate |
$43.32 |
| Max. Negotiated Rate |
$876.20 |
| Rate for Payer: Aetna Commercial |
$208.33
|
| Rate for Payer: Aetna Medicare |
$161.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.88
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$155.47
|
| Rate for Payer: BCBS Trust/PPO |
$43.32
|
| Rate for Payer: BCN Commercial |
$876.20
|
| Rate for Payer: BCN Medicare Advantage |
$155.47
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$208.33
|
| Rate for Payer: Cofinity Commercial |
$223.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.24
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Nomi Health Commercial |
$186.56
|
| Rate for Payer: PACE SWMI |
$155.47
|
| Rate for Payer: PHP Commercial |
$217.66
|
| Rate for Payer: PHP Medicare Advantage |
$155.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.13
|
| Rate for Payer: Priority Health Medicare |
$155.47
|
| Rate for Payer: Priority Health Narrow Network |
$291.13
|
| Rate for Payer: Priority Health SBD |
$291.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.47
|
| Rate for Payer: UHC Medicare Advantage |
$155.47
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
| Rate for Payer: UMR Bronson Commercial |
$507.84
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43204
|
| Min. Negotiated Rate |
$85.63 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$170.90
|
| Rate for Payer: Aetna Medicare |
$132.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.66
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS MAPPO |
$127.54
|
| Rate for Payer: BCBS Trust/PPO |
$249.36
|
| Rate for Payer: BCN Commercial |
$194.01
|
| Rate for Payer: BCN Medicare Advantage |
$127.54
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$170.90
|
| Rate for Payer: Cofinity Commercial |
$183.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.92
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| Rate for Payer: Nomi Health Commercial |
$153.05
|
| Rate for Payer: PACE SWMI |
$127.54
|
| Rate for Payer: PHP Commercial |
$178.56
|
| Rate for Payer: PHP Medicare Advantage |
$127.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.05
|
| Rate for Payer: Priority Health Medicare |
$127.54
|
| Rate for Payer: Priority Health Narrow Network |
$238.05
|
| Rate for Payer: Priority Health SBD |
$238.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.54
|
| Rate for Payer: UHC Medicare Advantage |
$127.54
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
| Rate for Payer: UMR Bronson Commercial |
$507.84
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION
|
Professional
|
Both
|
$639.00
|
|
|
Service Code
|
HCPCS 43229
|
| Min. Negotiated Rate |
$123.53 |
| Max. Negotiated Rate |
$1,048.21 |
| Rate for Payer: Aetna Commercial |
$248.28
|
| Rate for Payer: Aetna Medicare |
$192.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.80
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$185.28
|
| Rate for Payer: BCBS Trust/PPO |
$123.53
|
| Rate for Payer: BCN Commercial |
$1,048.21
|
| Rate for Payer: BCN Medicare Advantage |
$185.28
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cofinity Commercial |
$248.28
|
| Rate for Payer: Cofinity Commercial |
$266.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.54
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$222.34
|
| Rate for Payer: PACE SWMI |
$185.28
|
| Rate for Payer: PHP Commercial |
$259.39
|
| Rate for Payer: PHP Medicare Advantage |
$185.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$415.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$346.62
|
| Rate for Payer: Priority Health Medicare |
$185.28
|
| Rate for Payer: Priority Health Narrow Network |
$346.62
|
| Rate for Payer: Priority Health SBD |
$346.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.28
|
| Rate for Payer: UHC Medicare Advantage |
$185.28
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
| Rate for Payer: UMR Bronson Commercial |
$293.94
|
|
|
PR ESOPHAGOSCOPY,INSERT TUBE/STENT
|
Professional
|
Both
|
$1,496.00
|
|
|
Service Code
|
HCPCS 43219
|
| Min. Negotiated Rate |
$598.40 |
| Max. Negotiated Rate |
$972.40 |
| Rate for Payer: Aetna Medicare |
$748.00
|
| Rate for Payer: BCBS Complete |
$598.40
|
| Rate for Payer: Cash Price |
$1,196.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$972.40
|
| Rate for Payer: UMR Bronson Commercial |
$688.16
|
|
|
PR ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX
|
Professional
|
Both
|
$1,034.00
|
|
|
Service Code
|
HCPCS 43232
|
| Min. Negotiated Rate |
$81.89 |
| Max. Negotiated Rate |
$672.10 |
| Rate for Payer: Aetna Commercial |
$249.67
|
| Rate for Payer: Aetna Medicare |
$193.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.30
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$186.32
|
| Rate for Payer: BCBS Trust/PPO |
$81.89
|
| Rate for Payer: BCN Commercial |
$282.95
|
| Rate for Payer: BCN Medicare Advantage |
$186.32
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cash Price |
$827.20
|
| Rate for Payer: Cofinity Commercial |
$249.67
|
| Rate for Payer: Cofinity Commercial |
$268.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.64
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Nomi Health Commercial |
$223.58
|
| Rate for Payer: PACE SWMI |
$186.32
|
| Rate for Payer: PHP Commercial |
$260.85
|
| Rate for Payer: PHP Medicare Advantage |
$186.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$672.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.20
|
| Rate for Payer: Priority Health Medicare |
$186.32
|
| Rate for Payer: Priority Health Narrow Network |
$350.20
|
| Rate for Payer: Priority Health SBD |
$350.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.32
|
| Rate for Payer: UHC Medicare Advantage |
$186.32
|
| Rate for Payer: UHCCP Medicaid |
$124.82
|
| Rate for Payer: UMR Bronson Commercial |
$475.64
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 43195
|
| Min. Negotiated Rate |
$29.06 |
| Max. Negotiated Rate |
$330.51 |
| Rate for Payer: Aetna Commercial |
$237.92
|
| Rate for Payer: Aetna Medicare |
$184.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.67
|
| Rate for Payer: BCBS Complete |
$125.02
|
| Rate for Payer: BCBS MAPPO |
$177.55
|
| Rate for Payer: BCBS Trust/PPO |
$29.06
|
| Rate for Payer: BCN Commercial |
$269.26
|
| Rate for Payer: BCN Medicare Advantage |
$177.55
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$237.92
|
| Rate for Payer: Cofinity Commercial |
$255.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.43
|
| Rate for Payer: Meridian Medicaid |
$125.02
|
| Rate for Payer: Nomi Health Commercial |
$213.06
|
| Rate for Payer: PACE SWMI |
$177.55
|
| Rate for Payer: PHP Commercial |
$248.57
|
| Rate for Payer: PHP Medicare Advantage |
$177.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.51
|
| Rate for Payer: Priority Health Medicare |
$177.55
|
| Rate for Payer: Priority Health Narrow Network |
$330.51
|
| Rate for Payer: Priority Health SBD |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.55
|
| Rate for Payer: UHC Medicare Advantage |
$177.55
|
| Rate for Payer: UHCCP Medicaid |
$119.07
|
| Rate for Payer: UMR Bronson Commercial |
$175.26
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 43191
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$278.01 |
| Rate for Payer: Aetna Commercial |
$199.62
|
| Rate for Payer: Aetna Medicare |
$154.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.52
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$148.97
|
| Rate for Payer: BCBS Trust/PPO |
$63.92
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$148.97
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$199.62
|
| Rate for Payer: Cofinity Commercial |
$214.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.42
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Nomi Health Commercial |
$178.76
|
| Rate for Payer: PACE SWMI |
$148.97
|
| Rate for Payer: PHP Commercial |
$208.56
|
| Rate for Payer: PHP Medicare Advantage |
$148.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.01
|
| Rate for Payer: Priority Health Medicare |
$148.97
|
| Rate for Payer: Priority Health Narrow Network |
$278.01
|
| Rate for Payer: Priority Health SBD |
$278.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.97
|
| Rate for Payer: UHC Medicare Advantage |
$148.97
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
| Rate for Payer: UMR Bronson Commercial |
$184.92
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL
|
Professional
|
Both
|
$344.00
|
|
|
Service Code
|
HCPCS 43192
|
| Min. Negotiated Rate |
$77.66 |
| Max. Negotiated Rate |
$303.66 |
| Rate for Payer: Aetna Commercial |
$217.08
|
| Rate for Payer: Aetna Medicare |
$168.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.28
|
| Rate for Payer: BCBS Complete |
$114.28
|
| Rate for Payer: BCBS MAPPO |
$162.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$247.27
|
| Rate for Payer: BCN Medicare Advantage |
$162.00
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$217.08
|
| Rate for Payer: Cofinity Commercial |
$233.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.10
|
| Rate for Payer: Meridian Medicaid |
$114.28
|
| Rate for Payer: Nomi Health Commercial |
$194.40
|
| Rate for Payer: PACE SWMI |
$162.00
|
| Rate for Payer: PHP Commercial |
$226.80
|
| Rate for Payer: PHP Medicare Advantage |
$162.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.66
|
| Rate for Payer: Priority Health Medicare |
$162.00
|
| Rate for Payer: Priority Health Narrow Network |
$303.66
|
| Rate for Payer: Priority Health SBD |
$303.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.00
|
| Rate for Payer: UHC Medicare Advantage |
$162.00
|
| Rate for Payer: UHCCP Medicaid |
$108.84
|
| Rate for Payer: UMR Bronson Commercial |
$158.24
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$531.00
|
|
|
Service Code
|
HCPCS 43193
|
| Min. Negotiated Rate |
$46.49 |
| Max. Negotiated Rate |
$345.15 |
| Rate for Payer: Aetna Commercial |
$217.71
|
| Rate for Payer: Aetna Medicare |
$168.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.96
|
| Rate for Payer: BCBS Complete |
$114.51
|
| Rate for Payer: BCBS MAPPO |
$162.47
|
| Rate for Payer: BCBS Trust/PPO |
$46.49
|
| Rate for Payer: BCN Commercial |
$246.29
|
| Rate for Payer: BCN Medicare Advantage |
$162.47
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cofinity Commercial |
$217.71
|
| Rate for Payer: Cofinity Commercial |
$233.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.59
|
| Rate for Payer: Meridian Medicaid |
$114.51
|
| Rate for Payer: Nomi Health Commercial |
$194.96
|
| Rate for Payer: PACE SWMI |
$162.47
|
| Rate for Payer: PHP Commercial |
$227.46
|
| Rate for Payer: PHP Medicare Advantage |
$162.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$302.48
|
| Rate for Payer: Priority Health Medicare |
$162.47
|
| Rate for Payer: Priority Health Narrow Network |
$302.48
|
| Rate for Payer: Priority Health SBD |
$302.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.47
|
| Rate for Payer: UHC Medicare Advantage |
$162.47
|
| Rate for Payer: UHCCP Medicaid |
$109.06
|
| Rate for Payer: UMR Bronson Commercial |
$244.26
|
|
|
PR ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 43194
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$338.86 |
| Rate for Payer: Aetna Commercial |
$247.56
|
| Rate for Payer: Aetna Medicare |
$192.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.04
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCBS MAPPO |
$184.75
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$279.53
|
| Rate for Payer: BCN Medicare Advantage |
$184.75
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$247.56
|
| Rate for Payer: Cofinity Commercial |
$266.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.99
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Nomi Health Commercial |
$221.70
|
| Rate for Payer: PACE SWMI |
$184.75
|
| Rate for Payer: PHP Commercial |
$258.65
|
| Rate for Payer: PHP Medicare Advantage |
$184.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.86
|
| Rate for Payer: Priority Health Medicare |
$184.75
|
| Rate for Payer: Priority Health Narrow Network |
$338.86
|
| Rate for Payer: Priority Health SBD |
$338.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.75
|
| Rate for Payer: UHC Medicare Advantage |
$184.75
|
| Rate for Payer: UHCCP Medicaid |
$123.11
|
| Rate for Payer: UMR Bronson Commercial |
$221.26
|
|
|
PR ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 43212
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$373.10 |
| Rate for Payer: Aetna Commercial |
$242.02
|
| Rate for Payer: Aetna Medicare |
$187.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.08
|
| Rate for Payer: BCBS Complete |
$125.92
|
| Rate for Payer: BCBS MAPPO |
$180.61
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$272.68
|
| Rate for Payer: BCN Medicare Advantage |
$180.61
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$242.02
|
| Rate for Payer: Cofinity Commercial |
$260.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.64
|
| Rate for Payer: Meridian Medicaid |
$125.92
|
| Rate for Payer: Nomi Health Commercial |
$216.73
|
| Rate for Payer: PACE SWMI |
$180.61
|
| Rate for Payer: PHP Commercial |
$252.85
|
| Rate for Payer: PHP Medicare Advantage |
$180.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.89
|
| Rate for Payer: Priority Health Medicare |
$180.61
|
| Rate for Payer: Priority Health Narrow Network |
$332.89
|
| Rate for Payer: Priority Health SBD |
$332.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.61
|
| Rate for Payer: UHC Medicare Advantage |
$180.61
|
| Rate for Payer: UHCCP Medicaid |
$119.92
|
| Rate for Payer: UMR Bronson Commercial |
$264.04
|
|
|
PR ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH
|
Professional
|
Both
|
$1,322.00
|
|
|
Service Code
|
HCPCS 43180
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$981.40 |
| Rate for Payer: Aetna Commercial |
$703.55
|
| Rate for Payer: Aetna Medicare |
$546.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$756.06
|
| Rate for Payer: BCBS Complete |
$370.15
|
| Rate for Payer: BCBS MAPPO |
$525.04
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$525.04
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cash Price |
$1,057.60
|
| Rate for Payer: Cofinity Commercial |
$703.55
|
| Rate for Payer: Cofinity Commercial |
$756.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.29
|
| Rate for Payer: Meridian Medicaid |
$370.15
|
| Rate for Payer: Nomi Health Commercial |
$630.05
|
| Rate for Payer: PACE SWMI |
$525.04
|
| Rate for Payer: PHP Commercial |
$735.06
|
| Rate for Payer: PHP Medicare Advantage |
$525.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$859.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.40
|
| Rate for Payer: Priority Health Medicare |
$525.04
|
| Rate for Payer: Priority Health Narrow Network |
$981.40
|
| Rate for Payer: Priority Health SBD |
$981.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.04
|
| Rate for Payer: UHC Medicare Advantage |
$525.04
|
| Rate for Payer: UHCCP Medicaid |
$352.52
|
| Rate for Payer: UMR Bronson Commercial |
$608.12
|
|
|
PR ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR
|
Professional
|
Both
|
$2,389.00
|
|
|
Service Code
|
HCPCS 43352
|
| Min. Negotiated Rate |
$680.32 |
| Max. Negotiated Rate |
$1,895.98 |
| Rate for Payer: Aetna Commercial |
$1,379.42
|
| Rate for Payer: Aetna Medicare |
$1,070.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,482.36
|
| Rate for Payer: BCBS Complete |
$714.34
|
| Rate for Payer: BCBS MAPPO |
$1,029.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.75
|
| Rate for Payer: BCN Commercial |
$1,543.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.42
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cash Price |
$1,911.20
|
| Rate for Payer: Cofinity Commercial |
$1,379.42
|
| Rate for Payer: Cofinity Commercial |
$1,482.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,080.89
|
| Rate for Payer: Meridian Medicaid |
$714.34
|
| Rate for Payer: Nomi Health Commercial |
$1,235.30
|
| Rate for Payer: PACE SWMI |
$1,029.42
|
| Rate for Payer: PHP Commercial |
$1,441.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,552.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,895.98
|
| Rate for Payer: Priority Health Medicare |
$1,029.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,895.98
|
| Rate for Payer: Priority Health SBD |
$1,895.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,029.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,029.42
|
| Rate for Payer: UHCCP Medicaid |
$680.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.94
|
|
|
PR ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR
|
Professional
|
Both
|
$3,537.00
|
|
|
Service Code
|
HCPCS 43351
|
| Min. Negotiated Rate |
$840.07 |
| Max. Negotiated Rate |
$2,342.82 |
| Rate for Payer: Aetna Commercial |
$1,703.74
|
| Rate for Payer: Aetna Medicare |
$1,322.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,703.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,830.89
|
| Rate for Payer: BCBS Complete |
$882.07
|
| Rate for Payer: BCBS MAPPO |
$1,271.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.94
|
| Rate for Payer: BCN Commercial |
$1,905.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,271.45
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,703.74
|
| Rate for Payer: Cofinity Commercial |
$1,830.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,271.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,335.02
|
| Rate for Payer: Meridian Medicaid |
$882.07
|
| Rate for Payer: Nomi Health Commercial |
$1,525.74
|
| Rate for Payer: PACE SWMI |
$1,271.45
|
| Rate for Payer: PHP Commercial |
$1,780.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,271.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,299.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,342.82
|
| Rate for Payer: Priority Health Medicare |
$1,271.45
|
| Rate for Payer: Priority Health Narrow Network |
$2,342.82
|
| Rate for Payer: Priority Health SBD |
$2,342.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,271.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,271.45
|
| Rate for Payer: UHCCP Medicaid |
$840.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,627.02
|
|
|
PR ESOPHAGOTOMY THORACIC APPR W/RMVL FB
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 43045
|
| Min. Negotiated Rate |
$272.07 |
| Max. Negotiated Rate |
$2,314.79 |
| Rate for Payer: Aetna Commercial |
$1,683.67
|
| Rate for Payer: Aetna Medicare |
$1,306.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,683.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,809.32
|
| Rate for Payer: BCBS Complete |
$871.34
|
| Rate for Payer: BCBS MAPPO |
$1,256.47
|
| Rate for Payer: BCBS Trust/PPO |
$272.07
|
| Rate for Payer: BCN Commercial |
$1,883.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,256.47
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$1,809.32
|
| Rate for Payer: Cofinity Commercial |
$1,683.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,256.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,319.29
|
| Rate for Payer: Meridian Medicaid |
$871.34
|
| Rate for Payer: Nomi Health Commercial |
$1,507.76
|
| Rate for Payer: PACE SWMI |
$1,256.47
|
| Rate for Payer: PHP Commercial |
$1,759.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,256.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$829.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,314.79
|
| Rate for Payer: Priority Health Medicare |
$1,256.47
|
| Rate for Payer: Priority Health Narrow Network |
$2,314.79
|
| Rate for Payer: Priority Health SBD |
$2,314.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,256.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,256.47
|
| Rate for Payer: UHCCP Medicaid |
$829.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,506.96
|
|
|
PR ESOPHAGUS LENGTHENING
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 43338
|
| Min. Negotiated Rate |
$71.78 |
| Max. Negotiated Rate |
$200.46 |
| Rate for Payer: Aetna Commercial |
$147.72
|
| Rate for Payer: Aetna Medicare |
$114.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.75
|
| Rate for Payer: BCBS Complete |
$75.37
|
| Rate for Payer: BCBS MAPPO |
$110.24
|
| Rate for Payer: BCN Commercial |
$164.69
|
| Rate for Payer: BCN Medicare Advantage |
$110.24
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$147.72
|
| Rate for Payer: Cofinity Commercial |
$158.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.75
|
| Rate for Payer: Meridian Medicaid |
$75.37
|
| Rate for Payer: Nomi Health Commercial |
$132.29
|
| Rate for Payer: PACE SWMI |
$110.24
|
| Rate for Payer: PHP Commercial |
$154.34
|
| Rate for Payer: PHP Medicare Advantage |
$110.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.46
|
| Rate for Payer: Priority Health Medicare |
$110.24
|
| Rate for Payer: Priority Health Narrow Network |
$200.46
|
| Rate for Payer: Priority Health SBD |
$200.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.24
|
| Rate for Payer: UHC Medicare Advantage |
$110.24
|
| Rate for Payer: UHCCP Medicaid |
$71.78
|
| Rate for Payer: UMR Bronson Commercial |
$108.10
|
|
|
PR ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG
|
Professional
|
Both
|
$819.00
|
|
|
Service Code
|
HCPCS 91038
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$932.98 |
| Rate for Payer: Aetna Commercial |
$462.58
|
| Rate for Payer: Aetna Commercial |
$462.58
|
| Rate for Payer: Aetna Medicare |
$359.02
|
| Rate for Payer: Aetna Medicare |
$359.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.58
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$345.21
|
| Rate for Payer: BCBS MAPPO |
$345.21
|
| Rate for Payer: BCBS Trust/PPO |
$932.98
|
| Rate for Payer: BCBS Trust/PPO |
$932.98
|
| Rate for Payer: BCN Commercial |
$599.12
|
| Rate for Payer: BCN Commercial |
$599.12
|
| Rate for Payer: BCN Medicare Advantage |
$345.21
|
| Rate for Payer: BCN Medicare Advantage |
$345.21
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cofinity Commercial |
$462.58
|
| Rate for Payer: Cofinity Commercial |
$497.10
|
| Rate for Payer: Cofinity Commercial |
$497.10
|
| Rate for Payer: Cofinity Commercial |
$462.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.47
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$414.25
|
| Rate for Payer: Nomi Health Commercial |
$414.25
|
| Rate for Payer: PACE SWMI |
$345.21
|
| Rate for Payer: PACE SWMI |
$345.21
|
| Rate for Payer: PHP Commercial |
$483.29
|
| Rate for Payer: PHP Commercial |
$483.29
|
| Rate for Payer: PHP Medicare Advantage |
$345.21
|
| Rate for Payer: PHP Medicare Advantage |
$345.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$546.39
|
| Rate for Payer: Priority Health Medicare |
$345.21
|
| Rate for Payer: Priority Health Medicare |
$345.21
|
| Rate for Payer: Priority Health Narrow Network |
$546.39
|
| Rate for Payer: Priority Health Narrow Network |
$546.39
|
| Rate for Payer: Priority Health SBD |
$73.73
|
| Rate for Payer: Priority Health SBD |
$73.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.21
|
| Rate for Payer: UHC Medicare Advantage |
$345.21
|
| Rate for Payer: UHC Medicare Advantage |
$345.21
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$51.98
|
| Rate for Payer: UMR Bronson Commercial |
$376.74
|
|
|
PR ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43216
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Aetna Commercial |
$169.22
|
| Rate for Payer: Aetna Medicare |
$131.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.84
|
| Rate for Payer: BCBS Complete |
$89.01
|
| Rate for Payer: BCBS MAPPO |
$126.28
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$603.52
|
| Rate for Payer: BCN Medicare Advantage |
$126.28
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$169.22
|
| Rate for Payer: Cofinity Commercial |
$181.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.59
|
| Rate for Payer: Meridian Medicaid |
$89.01
|
| Rate for Payer: Nomi Health Commercial |
$151.54
|
| Rate for Payer: PACE SWMI |
$126.28
|
| Rate for Payer: PHP Commercial |
$176.79
|
| Rate for Payer: PHP Medicare Advantage |
$126.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.66
|
| Rate for Payer: Priority Health Medicare |
$126.28
|
| Rate for Payer: Priority Health Narrow Network |
$235.66
|
| Rate for Payer: Priority Health SBD |
$235.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.28
|
| Rate for Payer: UHC Medicare Advantage |
$126.28
|
| Rate for Payer: UHCCP Medicaid |
$84.77
|
| Rate for Payer: UMR Bronson Commercial |
$538.20
|
|
|
PR ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES
|
Professional
|
Both
|
$1,104.00
|
|
|
Service Code
|
HCPCS 43205
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$717.60 |
| Rate for Payer: Aetna Commercial |
$177.26
|
| Rate for Payer: Aetna Medicare |
$137.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.48
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$132.28
|
| Rate for Payer: BCBS Trust/PPO |
$278.94
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$132.28
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cofinity Commercial |
$177.26
|
| Rate for Payer: Cofinity Commercial |
$190.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.89
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Nomi Health Commercial |
$158.74
|
| Rate for Payer: PACE SWMI |
$132.28
|
| Rate for Payer: PHP Commercial |
$185.19
|
| Rate for Payer: PHP Medicare Advantage |
$132.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$717.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.78
|
| Rate for Payer: Priority Health Medicare |
$132.28
|
| Rate for Payer: Priority Health Narrow Network |
$248.78
|
| Rate for Payer: Priority Health SBD |
$248.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.28
|
| Rate for Payer: UHC Medicare Advantage |
$132.28
|
| Rate for Payer: UHCCP Medicaid |
$88.82
|
| Rate for Payer: UMR Bronson Commercial |
$507.84
|
|
|
PR ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL
|
Professional
|
Both
|
$6,658.00
|
|
|
Service Code
|
HCPCS 43313
|
| Min. Negotiated Rate |
$1,290.11 |
| Max. Negotiated Rate |
$5,185.60 |
| Rate for Payer: Aetna Commercial |
$3,779.36
|
| Rate for Payer: Aetna Medicare |
$2,933.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,779.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,061.40
|
| Rate for Payer: BCBS Complete |
$1,955.37
|
| Rate for Payer: BCBS MAPPO |
$2,820.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.11
|
| Rate for Payer: BCN Commercial |
$4,222.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,820.42
|
| Rate for Payer: Cash Price |
$5,326.40
|
| Rate for Payer: Cash Price |
$5,326.40
|
| Rate for Payer: Cofinity Commercial |
$3,779.36
|
| Rate for Payer: Cofinity Commercial |
$4,061.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,820.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,961.44
|
| Rate for Payer: Meridian Medicaid |
$1,955.37
|
| Rate for Payer: Nomi Health Commercial |
$3,384.50
|
| Rate for Payer: PACE SWMI |
$2,820.42
|
| Rate for Payer: PHP Commercial |
$3,948.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,820.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,862.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,327.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,185.60
|
| Rate for Payer: Priority Health Medicare |
$2,820.42
|
| Rate for Payer: Priority Health Narrow Network |
$5,185.60
|
| Rate for Payer: Priority Health SBD |
$5,185.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,820.42
|
| Rate for Payer: UHC Medicare Advantage |
$2,820.42
|
| Rate for Payer: UHCCP Medicaid |
$1,862.26
|
| Rate for Payer: UMR Bronson Commercial |
$3,062.68
|
|
|
PR ESPHGP CGEN DFCT THRC APPR W/RPR FSTL
|
Professional
|
Both
|
$7,567.00
|
|
|
Service Code
|
HCPCS 43314
|
| Min. Negotiated Rate |
$1,288.00 |
| Max. Negotiated Rate |
$5,547.72 |
| Rate for Payer: Aetna Commercial |
$4,050.31
|
| Rate for Payer: Aetna Medicare |
$3,143.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,050.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,352.57
|
| Rate for Payer: BCBS Complete |
$2,089.78
|
| Rate for Payer: BCBS MAPPO |
$3,022.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.00
|
| Rate for Payer: BCN Commercial |
$4,525.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,022.62
|
| Rate for Payer: Cash Price |
$6,053.60
|
| Rate for Payer: Cash Price |
$6,053.60
|
| Rate for Payer: Cofinity Commercial |
$4,050.31
|
| Rate for Payer: Cofinity Commercial |
$4,352.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,022.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,173.75
|
| Rate for Payer: Meridian Medicaid |
$2,089.78
|
| Rate for Payer: Nomi Health Commercial |
$3,627.14
|
| Rate for Payer: PACE SWMI |
$3,022.62
|
| Rate for Payer: PHP Commercial |
$4,231.67
|
| Rate for Payer: PHP Medicare Advantage |
$3,022.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,990.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,918.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,547.72
|
| Rate for Payer: Priority Health Medicare |
$3,022.62
|
| Rate for Payer: Priority Health Narrow Network |
$5,547.72
|
| Rate for Payer: Priority Health SBD |
$5,547.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,022.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,022.62
|
| Rate for Payer: UHCCP Medicaid |
$1,990.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,480.82
|
|
|
PR ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL
|
Professional
|
Both
|
$2,072.00
|
|
|
Service Code
|
HCPCS 43300
|
| Min. Negotiated Rate |
$405.13 |
| Max. Negotiated Rate |
$1,573.28 |
| Rate for Payer: Aetna Commercial |
$802.47
|
| Rate for Payer: Aetna Medicare |
$622.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$862.36
|
| Rate for Payer: BCBS Complete |
$425.39
|
| Rate for Payer: BCBS MAPPO |
$598.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.28
|
| Rate for Payer: BCN Commercial |
$919.69
|
| Rate for Payer: BCN Medicare Advantage |
$598.86
|
| Rate for Payer: Cash Price |
$1,657.60
|
| Rate for Payer: Cash Price |
$1,657.60
|
| Rate for Payer: Cofinity Commercial |
$862.36
|
| Rate for Payer: Cofinity Commercial |
$802.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.80
|
| Rate for Payer: Meridian Medicaid |
$425.39
|
| Rate for Payer: Nomi Health Commercial |
$718.63
|
| Rate for Payer: PACE SWMI |
$598.86
|
| Rate for Payer: PHP Commercial |
$838.40
|
| Rate for Payer: PHP Medicare Advantage |
$598.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,346.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,130.55
|
| Rate for Payer: Priority Health Medicare |
$598.86
|
| Rate for Payer: Priority Health Narrow Network |
$1,130.55
|
| Rate for Payer: Priority Health SBD |
$1,130.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.86
|
| Rate for Payer: UHC Medicare Advantage |
$598.86
|
| Rate for Payer: UHCCP Medicaid |
$405.13
|
| Rate for Payer: UMR Bronson Commercial |
$953.12
|
|
|
PR ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 43305
|
| Min. Negotiated Rate |
$703.75 |
| Max. Negotiated Rate |
$1,965.18 |
| Rate for Payer: Aetna Commercial |
$1,404.21
|
| Rate for Payer: Aetna Medicare |
$1,089.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,509.00
|
| Rate for Payer: BCBS Complete |
$738.94
|
| Rate for Payer: BCBS MAPPO |
$1,047.92
|
| Rate for Payer: BCN Commercial |
$1,603.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,047.92
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$1,404.21
|
| Rate for Payer: Cofinity Commercial |
$1,509.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,047.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.32
|
| Rate for Payer: Meridian Medicaid |
$738.94
|
| Rate for Payer: Nomi Health Commercial |
$1,257.50
|
| Rate for Payer: PACE SWMI |
$1,047.92
|
| Rate for Payer: PHP Commercial |
$1,467.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,047.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,965.18
|
| Rate for Payer: Priority Health Medicare |
$1,047.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,965.18
|
| Rate for Payer: Priority Health SBD |
$1,965.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,047.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,047.92
|
| Rate for Payer: UHCCP Medicaid |
$703.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.98
|
|
