|
PR ERCP,BALLOON DIL DUCTS
|
Professional
|
Both
|
$1,722.00
|
|
|
Service Code
|
HCPCS 43271
|
| Min. Negotiated Rate |
$688.80 |
| Max. Negotiated Rate |
$1,291.50 |
| Rate for Payer: BCBS Complete |
$688.80
|
| Rate for Payer: Cash Price |
$1,377.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,291.50
|
|
|
PR ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE
|
Professional
|
Both
|
$1,532.00
|
|
|
Service Code
|
HCPCS 43276
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$1,149.00 |
| Rate for Payer: Aetna Commercial |
$555.87
|
| Rate for Payer: Aetna Medicare |
$414.83
|
| Rate for Payer: BCBS Complete |
$280.69
|
| Rate for Payer: BCBS MAPPO |
$414.83
|
| Rate for Payer: BCN Commercial |
$705.64
|
| Rate for Payer: BCN Medicare Advantage |
$414.83
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cash Price |
$1,225.60
|
| Rate for Payer: Cofinity Commercial |
$555.87
|
| Rate for Payer: Cofinity Commercial |
$597.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.83
|
| Rate for Payer: Healthscope Commercial |
$497.80
|
| Rate for Payer: Healthscope Whirlpool |
$497.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$435.57
|
| Rate for Payer: Meridian Medicaid |
$280.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$456.31
|
| Rate for Payer: Nomi Health Commercial |
$497.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,149.00
|
| Rate for Payer: PACE SWMI |
$414.83
|
| Rate for Payer: PHP Medicare Advantage |
$414.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$859.78
|
| Rate for Payer: Priority Health Medicare |
$414.83
|
| Rate for Payer: Priority Health Narrow Network |
$859.78
|
| Rate for Payer: Railroad Medicare Medicare |
$414.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$850.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$414.83
|
| Rate for Payer: UHC Exchange |
$850.70
|
| Rate for Payer: UHC Medicaid |
$267.32
|
| Rate for Payer: UHCCP DNSP |
$414.83
|
| Rate for Payer: UHCCP Medicaid |
$267.32
|
|
|
PR ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD
|
Professional
|
Both
|
$1,962.00
|
|
|
Service Code
|
HCPCS 43265
|
| Min. Negotiated Rate |
$240.26 |
| Max. Negotiated Rate |
$1,471.50 |
| Rate for Payer: Aetna Commercial |
$499.44
|
| Rate for Payer: Aetna Medicare |
$372.72
|
| Rate for Payer: BCBS Complete |
$252.27
|
| Rate for Payer: BCBS MAPPO |
$372.72
|
| Rate for Payer: BCN Commercial |
$633.93
|
| Rate for Payer: BCN Medicare Advantage |
$372.72
|
| Rate for Payer: Cash Price |
$1,569.60
|
| Rate for Payer: Cash Price |
$1,569.60
|
| Rate for Payer: Cofinity Commercial |
$536.72
|
| Rate for Payer: Cofinity Commercial |
$499.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.72
|
| Rate for Payer: Healthscope Commercial |
$447.26
|
| Rate for Payer: Healthscope Whirlpool |
$447.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.36
|
| Rate for Payer: Meridian Medicaid |
$252.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.99
|
| Rate for Payer: Nomi Health Commercial |
$447.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,471.50
|
| Rate for Payer: PACE SWMI |
$372.72
|
| Rate for Payer: PHP Medicare Advantage |
$372.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$772.40
|
| Rate for Payer: Priority Health Medicare |
$372.72
|
| Rate for Payer: Priority Health Narrow Network |
$772.40
|
| Rate for Payer: Railroad Medicare Medicare |
$372.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.72
|
| Rate for Payer: UHC Exchange |
$765.57
|
| Rate for Payer: UHC Medicaid |
$240.26
|
| Rate for Payer: UHCCP DNSP |
$372.72
|
| Rate for Payer: UHCCP Medicaid |
$240.26
|
|
|
PR ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 43260
|
| Min. Negotiated Rate |
$179.13 |
| Max. Negotiated Rate |
$852.75 |
| Rate for Payer: Aetna Commercial |
$371.85
|
| Rate for Payer: Aetna Medicare |
$277.50
|
| Rate for Payer: BCBS Complete |
$188.09
|
| Rate for Payer: BCBS MAPPO |
$277.50
|
| Rate for Payer: BCN Commercial |
$473.58
|
| Rate for Payer: BCN Medicare Advantage |
$277.50
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$399.60
|
| Rate for Payer: Cofinity Commercial |
$371.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.50
|
| Rate for Payer: Healthscope Commercial |
$333.00
|
| Rate for Payer: Healthscope Whirlpool |
$333.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.38
|
| Rate for Payer: Meridian Medicaid |
$188.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$305.25
|
| Rate for Payer: Nomi Health Commercial |
$333.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.75
|
| Rate for Payer: PACE SWMI |
$277.50
|
| Rate for Payer: PHP Medicare Advantage |
$277.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$577.04
|
| Rate for Payer: Priority Health Medicare |
$277.50
|
| Rate for Payer: Priority Health Narrow Network |
$577.04
|
| Rate for Payer: Railroad Medicare Medicare |
$277.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$569.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$277.50
|
| Rate for Payer: UHC Exchange |
$569.43
|
| Rate for Payer: UHC Medicaid |
$179.13
|
| Rate for Payer: UHCCP DNSP |
$277.50
|
| Rate for Payer: UHCCP Medicaid |
$179.13
|
|
|
PR ERCP,INSERT STENT,BILIARY/PANC
|
Professional
|
Both
|
$1,756.00
|
|
|
Service Code
|
HCPCS 43268
|
| Min. Negotiated Rate |
$702.40 |
| Max. Negotiated Rate |
$1,317.00 |
| Rate for Payer: BCBS Complete |
$702.40
|
| Rate for Payer: Cash Price |
$1,404.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,317.00
|
|
|
PR ERCP,NASOBILIARY DRAIN TUBE
|
Professional
|
Both
|
$1,698.00
|
|
|
Service Code
|
HCPCS 43267
|
| Min. Negotiated Rate |
$679.20 |
| Max. Negotiated Rate |
$1,273.50 |
| Rate for Payer: BCBS Complete |
$679.20
|
| Rate for Payer: Cash Price |
$1,358.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,273.50
|
|
|
PR ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT
|
Professional
|
Both
|
$1,894.00
|
|
|
Service Code
|
HCPCS 43264
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$1,420.50 |
| Rate for Payer: Aetna Commercial |
$420.32
|
| Rate for Payer: Aetna Medicare |
$313.67
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$313.67
|
| Rate for Payer: BCN Commercial |
$534.83
|
| Rate for Payer: BCN Medicare Advantage |
$313.67
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Cofinity Commercial |
$451.68
|
| Rate for Payer: Cofinity Commercial |
$420.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.67
|
| Rate for Payer: Healthscope Commercial |
$376.40
|
| Rate for Payer: Healthscope Whirlpool |
$376.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.35
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$345.04
|
| Rate for Payer: Nomi Health Commercial |
$376.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,420.50
|
| Rate for Payer: PACE SWMI |
$313.67
|
| Rate for Payer: PHP Medicare Advantage |
$313.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$651.65
|
| Rate for Payer: Priority Health Medicare |
$313.67
|
| Rate for Payer: Priority Health Narrow Network |
$651.65
|
| Rate for Payer: Railroad Medicare Medicare |
$313.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$641.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$313.67
|
| Rate for Payer: UHC Exchange |
$641.71
|
| Rate for Payer: UHC Medicaid |
$202.35
|
| Rate for Payer: UHCCP DNSP |
$313.67
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
|
|
PR ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT
|
Professional
|
Both
|
$843.00
|
|
|
Service Code
|
HCPCS 43275
|
| Min. Negotiated Rate |
$209.38 |
| Max. Negotiated Rate |
$672.89 |
| Rate for Payer: Aetna Commercial |
$435.08
|
| Rate for Payer: Aetna Medicare |
$324.69
|
| Rate for Payer: BCBS Complete |
$219.85
|
| Rate for Payer: BCBS MAPPO |
$324.69
|
| Rate for Payer: BCN Commercial |
$552.26
|
| Rate for Payer: BCN Medicare Advantage |
$324.69
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cofinity Commercial |
$435.08
|
| Rate for Payer: Cofinity Commercial |
$467.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.69
|
| Rate for Payer: Healthscope Commercial |
$389.63
|
| Rate for Payer: Healthscope Whirlpool |
$389.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.92
|
| Rate for Payer: Meridian Medicaid |
$219.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$357.16
|
| Rate for Payer: Nomi Health Commercial |
$389.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.25
|
| Rate for Payer: PACE SWMI |
$324.69
|
| Rate for Payer: PHP Medicare Advantage |
$324.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$672.89
|
| Rate for Payer: Priority Health Medicare |
$324.69
|
| Rate for Payer: Priority Health Narrow Network |
$672.89
|
| Rate for Payer: Railroad Medicare Medicare |
$324.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$664.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$324.69
|
| Rate for Payer: UHC Exchange |
$664.47
|
| Rate for Payer: UHC Medicaid |
$209.38
|
| Rate for Payer: UHCCP DNSP |
$324.69
|
| Rate for Payer: UHCCP Medicaid |
$209.38
|
|
|
PR ERCP,RMV F.B./CHANGE STENT
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 43269
|
| Min. Negotiated Rate |
$697.60 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: BCBS Complete |
$697.60
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
|
|
PR ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT
|
Professional
|
Both
|
$1,472.00
|
|
|
Service Code
|
HCPCS 43274
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$1,104.00 |
| Rate for Payer: Aetna Commercial |
$533.09
|
| Rate for Payer: Aetna Medicare |
$397.83
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$397.83
|
| Rate for Payer: BCN Commercial |
$678.25
|
| Rate for Payer: BCN Medicare Advantage |
$397.83
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cash Price |
$1,177.60
|
| Rate for Payer: Cofinity Commercial |
$572.88
|
| Rate for Payer: Cofinity Commercial |
$533.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.83
|
| Rate for Payer: Healthscope Commercial |
$477.40
|
| Rate for Payer: Healthscope Whirlpool |
$477.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.72
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.61
|
| Rate for Payer: Nomi Health Commercial |
$477.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,104.00
|
| Rate for Payer: PACE SWMI |
$397.83
|
| Rate for Payer: PHP Medicare Advantage |
$397.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$826.40
|
| Rate for Payer: Priority Health Medicare |
$397.83
|
| Rate for Payer: Priority Health Narrow Network |
$826.40
|
| Rate for Payer: Railroad Medicare Medicare |
$397.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$817.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$397.83
|
| Rate for Payer: UHC Exchange |
$817.66
|
| Rate for Payer: UHC Medicaid |
$256.45
|
| Rate for Payer: UHCCP DNSP |
$397.83
|
| Rate for Payer: UHCCP Medicaid |
$256.45
|
|
|
PR ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE
|
Professional
|
Both
|
$1,388.00
|
|
|
Service Code
|
HCPCS 43278
|
| Min. Negotiated Rate |
$240.05 |
| Max. Negotiated Rate |
$1,041.00 |
| Rate for Payer: Aetna Commercial |
$499.00
|
| Rate for Payer: Aetna Medicare |
$372.39
|
| Rate for Payer: BCBS Complete |
$252.05
|
| Rate for Payer: BCBS MAPPO |
$372.39
|
| Rate for Payer: BCN Commercial |
$634.93
|
| Rate for Payer: BCN Medicare Advantage |
$372.39
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cash Price |
$1,110.40
|
| Rate for Payer: Cofinity Commercial |
$536.24
|
| Rate for Payer: Cofinity Commercial |
$499.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.39
|
| Rate for Payer: Healthscope Commercial |
$446.87
|
| Rate for Payer: Healthscope Whirlpool |
$446.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.01
|
| Rate for Payer: Meridian Medicaid |
$252.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.63
|
| Rate for Payer: Nomi Health Commercial |
$446.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.00
|
| Rate for Payer: PACE SWMI |
$372.39
|
| Rate for Payer: PHP Medicare Advantage |
$372.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$773.62
|
| Rate for Payer: Priority Health Medicare |
$372.39
|
| Rate for Payer: Priority Health Narrow Network |
$773.62
|
| Rate for Payer: Railroad Medicare Medicare |
$372.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$765.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$372.39
|
| Rate for Payer: UHC Exchange |
$765.57
|
| Rate for Payer: UHC Medicaid |
$240.05
|
| Rate for Payer: UHCCP DNSP |
$372.39
|
| Rate for Payer: UHCCP Medicaid |
$240.05
|
|
|
PR ERCP W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 43261
|
| Min. Negotiated Rate |
$188.51 |
| Max. Negotiated Rate |
$903.75 |
| Rate for Payer: Aetna Commercial |
$391.48
|
| Rate for Payer: Aetna Medicare |
$292.15
|
| Rate for Payer: BCBS Complete |
$197.94
|
| Rate for Payer: BCBS MAPPO |
$292.15
|
| Rate for Payer: BCN Commercial |
$496.49
|
| Rate for Payer: BCN Medicare Advantage |
$292.15
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$420.70
|
| Rate for Payer: Cofinity Commercial |
$391.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.15
|
| Rate for Payer: Healthscope Commercial |
$350.58
|
| Rate for Payer: Healthscope Whirlpool |
$350.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.76
|
| Rate for Payer: Meridian Medicaid |
$197.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.37
|
| Rate for Payer: Nomi Health Commercial |
$350.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PACE SWMI |
$292.15
|
| Rate for Payer: PHP Medicare Advantage |
$292.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$604.93
|
| Rate for Payer: Priority Health Medicare |
$292.15
|
| Rate for Payer: Priority Health Narrow Network |
$604.93
|
| Rate for Payer: Railroad Medicare Medicare |
$292.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$596.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$292.15
|
| Rate for Payer: UHC Exchange |
$596.99
|
| Rate for Payer: UHC Medicaid |
$188.51
|
| Rate for Payer: UHCCP DNSP |
$292.15
|
| Rate for Payer: UHCCP Medicaid |
$188.51
|
|
|
PR ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI
|
Professional
|
Both
|
$1,671.00
|
|
|
Service Code
|
HCPCS 43263
|
| Min. Negotiated Rate |
$198.94 |
| Max. Negotiated Rate |
$1,253.25 |
| Rate for Payer: Aetna Commercial |
$413.12
|
| Rate for Payer: Aetna Medicare |
$308.30
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$308.30
|
| Rate for Payer: BCN Commercial |
$524.87
|
| Rate for Payer: BCN Medicare Advantage |
$308.30
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cash Price |
$1,336.80
|
| Rate for Payer: Cofinity Commercial |
$443.95
|
| Rate for Payer: Cofinity Commercial |
$413.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.30
|
| Rate for Payer: Healthscope Commercial |
$369.96
|
| Rate for Payer: Healthscope Whirlpool |
$369.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.71
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.13
|
| Rate for Payer: Nomi Health Commercial |
$369.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,253.25
|
| Rate for Payer: PACE SWMI |
$308.30
|
| Rate for Payer: PHP Medicare Advantage |
$308.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$639.52
|
| Rate for Payer: Priority Health Medicare |
$308.30
|
| Rate for Payer: Priority Health Narrow Network |
$639.52
|
| Rate for Payer: Railroad Medicare Medicare |
$308.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$630.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$308.30
|
| Rate for Payer: UHC Exchange |
$630.05
|
| Rate for Payer: UHC Medicaid |
$198.94
|
| Rate for Payer: UHCCP DNSP |
$308.30
|
| Rate for Payer: UHCCP Medicaid |
$198.94
|
|
|
PR ERCP W/SPHINCTEROTOMY/PAPILLOTOMY
|
Professional
|
Both
|
$1,739.00
|
|
|
Service Code
|
HCPCS 43262
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,304.25 |
| Rate for Payer: Aetna Commercial |
$412.30
|
| Rate for Payer: Aetna Medicare |
$307.69
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$307.69
|
| Rate for Payer: BCN Commercial |
$523.88
|
| Rate for Payer: BCN Medicare Advantage |
$307.69
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cash Price |
$1,391.20
|
| Rate for Payer: Cofinity Commercial |
$443.07
|
| Rate for Payer: Cofinity Commercial |
$412.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.69
|
| Rate for Payer: Healthscope Commercial |
$369.23
|
| Rate for Payer: Healthscope Whirlpool |
$369.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.07
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.46
|
| Rate for Payer: Nomi Health Commercial |
$369.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,304.25
|
| Rate for Payer: PACE SWMI |
$307.69
|
| Rate for Payer: PHP Medicare Advantage |
$307.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$638.32
|
| Rate for Payer: Priority Health Medicare |
$307.69
|
| Rate for Payer: Priority Health Narrow Network |
$638.32
|
| Rate for Payer: Railroad Medicare Medicare |
$307.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$630.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.69
|
| Rate for Payer: UHC Exchange |
$630.05
|
| Rate for Payer: UHC Medicaid |
$198.52
|
| Rate for Payer: UHCCP DNSP |
$307.69
|
| Rate for Payer: UHCCP Medicaid |
$198.52
|
|
|
PR ESCHAROTOMY EACH ADDITIONAL INCISION
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 16036
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$335.25 |
| Rate for Payer: Aetna Commercial |
$99.07
|
| Rate for Payer: Aetna Medicare |
$73.93
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$73.93
|
| Rate for Payer: BCN Commercial |
$123.00
|
| Rate for Payer: BCN Medicare Advantage |
$73.93
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cofinity Commercial |
$99.07
|
| Rate for Payer: Cofinity Commercial |
$106.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.93
|
| Rate for Payer: Healthscope Commercial |
$88.72
|
| Rate for Payer: Healthscope Whirlpool |
$88.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.63
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.32
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.25
|
| Rate for Payer: PACE SWMI |
$73.93
|
| Rate for Payer: PHP Medicare Advantage |
$73.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$112.58
|
| Rate for Payer: Priority Health Medicare |
$73.93
|
| Rate for Payer: Priority Health Narrow Network |
$112.58
|
| Rate for Payer: Railroad Medicare Medicare |
$73.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.93
|
| Rate for Payer: UHC Exchange |
$145.66
|
| Rate for Payer: UHC Medicaid |
$46.86
|
| Rate for Payer: UHCCP DNSP |
$73.93
|
| Rate for Payer: UHCCP Medicaid |
$46.86
|
|
|
PR ESCHAROTOMY INITIAL INCISION
|
Professional
|
Both
|
$886.00
|
|
|
Service Code
|
HCPCS 16035
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$664.50 |
| Rate for Payer: Aetna Commercial |
$239.11
|
| Rate for Payer: Aetna Medicare |
$178.44
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCBS MAPPO |
$178.44
|
| Rate for Payer: BCN Commercial |
$291.32
|
| Rate for Payer: BCN Medicare Advantage |
$178.44
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cash Price |
$708.80
|
| Rate for Payer: Cofinity Commercial |
$256.95
|
| Rate for Payer: Cofinity Commercial |
$239.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.44
|
| Rate for Payer: Healthscope Commercial |
$214.13
|
| Rate for Payer: Healthscope Whirlpool |
$214.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.36
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$196.28
|
| Rate for Payer: Nomi Health Commercial |
$214.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$664.50
|
| Rate for Payer: PACE SWMI |
$178.44
|
| Rate for Payer: PHP Medicare Advantage |
$178.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$266.64
|
| Rate for Payer: Priority Health Medicare |
$178.44
|
| Rate for Payer: Priority Health Narrow Network |
$266.64
|
| Rate for Payer: Railroad Medicare Medicare |
$178.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$178.44
|
| Rate for Payer: UHC Exchange |
$351.01
|
| Rate for Payer: UHC Medicaid |
$113.96
|
| Rate for Payer: UHCCP DNSP |
$178.44
|
| Rate for Payer: UHCCP Medicaid |
$113.96
|
|
|
PR ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH
|
Professional
|
Both
|
$3,570.00
|
|
|
Service Code
|
HCPCS 43325
|
| Min. Negotiated Rate |
$811.74 |
| Max. Negotiated Rate |
$2,677.50 |
| Rate for Payer: Aetna Commercial |
$1,700.06
|
| Rate for Payer: Aetna Medicare |
$1,268.70
|
| Rate for Payer: BCBS Complete |
$852.33
|
| Rate for Payer: BCBS MAPPO |
$1,268.70
|
| Rate for Payer: BCN Commercial |
$2,041.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,268.70
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$1,826.93
|
| Rate for Payer: Cofinity Commercial |
$1,700.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,268.70
|
| Rate for Payer: Healthscope Commercial |
$1,522.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,522.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,332.13
|
| Rate for Payer: Meridian Medicaid |
$852.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,395.57
|
| Rate for Payer: Nomi Health Commercial |
$1,522.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.50
|
| Rate for Payer: PACE SWMI |
$1,268.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,268.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$811.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,487.71
|
| Rate for Payer: Priority Health Medicare |
$1,268.70
|
| Rate for Payer: Priority Health Narrow Network |
$2,487.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,268.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,426.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,268.70
|
| Rate for Payer: UHC Exchange |
$2,426.08
|
| Rate for Payer: UHC Medicaid |
$811.74
|
| Rate for Payer: UHCCP DNSP |
$1,268.70
|
| Rate for Payer: UHCCP Medicaid |
$811.74
|
|
|
PR ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY
|
Professional
|
Both
|
$2,159.00
|
|
|
Service Code
|
HCPCS 43327
|
| Min. Negotiated Rate |
$504.60 |
| Max. Negotiated Rate |
$1,619.25 |
| Rate for Payer: Aetna Commercial |
$1,052.30
|
| Rate for Payer: Aetna Medicare |
$785.30
|
| Rate for Payer: BCBS Complete |
$529.83
|
| Rate for Payer: BCBS MAPPO |
$785.30
|
| Rate for Payer: BCN Commercial |
$1,255.91
|
| Rate for Payer: BCN Medicare Advantage |
$785.30
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Cofinity Commercial |
$1,130.83
|
| Rate for Payer: Cofinity Commercial |
$1,052.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.30
|
| Rate for Payer: Healthscope Commercial |
$942.36
|
| Rate for Payer: Healthscope Whirlpool |
$942.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$824.57
|
| Rate for Payer: Meridian Medicaid |
$529.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$863.83
|
| Rate for Payer: Nomi Health Commercial |
$942.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,619.25
|
| Rate for Payer: PACE SWMI |
$785.30
|
| Rate for Payer: PHP Medicare Advantage |
$785.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,530.24
|
| Rate for Payer: Priority Health Medicare |
$785.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,530.24
|
| Rate for Payer: Railroad Medicare Medicare |
$785.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,461.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$785.30
|
| Rate for Payer: UHC Exchange |
$1,461.29
|
| Rate for Payer: UHC Medicaid |
$504.60
|
| Rate for Payer: UHCCP DNSP |
$785.30
|
| Rate for Payer: UHCCP Medicaid |
$504.60
|
|
|
PR ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 43460
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$684.75 |
| Rate for Payer: Aetna Commercial |
$248.11
|
| Rate for Payer: Aetna Medicare |
$185.16
|
| Rate for Payer: BCBS Complete |
$125.70
|
| Rate for Payer: BCBS MAPPO |
$185.16
|
| Rate for Payer: BCN Commercial |
$313.73
|
| Rate for Payer: BCN Medicare Advantage |
$185.16
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$266.63
|
| Rate for Payer: Cofinity Commercial |
$248.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.16
|
| Rate for Payer: Healthscope Commercial |
$222.19
|
| Rate for Payer: Healthscope Whirlpool |
$222.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.42
|
| Rate for Payer: Meridian Medicaid |
$125.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.68
|
| Rate for Payer: Nomi Health Commercial |
$222.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$684.75
|
| Rate for Payer: PACE SWMI |
$185.16
|
| Rate for Payer: PHP Medicare Advantage |
$185.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$382.25
|
| Rate for Payer: Priority Health Medicare |
$185.16
|
| Rate for Payer: Priority Health Narrow Network |
$382.25
|
| Rate for Payer: Railroad Medicare Medicare |
$185.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.16
|
| Rate for Payer: UHC Exchange |
$374.60
|
| Rate for Payer: UHC Medicaid |
$119.71
|
| Rate for Payer: UHCCP DNSP |
$185.16
|
| Rate for Payer: UHCCP Medicaid |
$119.71
|
|
|
PR ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 91013
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Commercial |
$35.54
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: BCBS MAPPO |
$26.52
|
| Rate for Payer: BCN Commercial |
$37.35
|
| Rate for Payer: BCN Medicare Advantage |
$26.52
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$35.54
|
| Rate for Payer: Cofinity Commercial |
$38.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.52
|
| Rate for Payer: Healthscope Commercial |
$31.82
|
| Rate for Payer: Healthscope Whirlpool |
$31.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.17
|
| Rate for Payer: Nomi Health Commercial |
$31.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$26.52
|
| Rate for Payer: PHP Medicare Advantage |
$26.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$34.44
|
| Rate for Payer: Priority Health Medicare |
$26.52
|
| Rate for Payer: Priority Health Narrow Network |
$34.44
|
| Rate for Payer: Railroad Medicare Medicare |
$26.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.52
|
| Rate for Payer: UHC Exchange |
$39.75
|
| Rate for Payer: UHCCP DNSP |
$26.52
|
|
|
PR ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 91010
|
| Min. Negotiated Rate |
$228.73 |
| Max. Negotiated Rate |
$329.37 |
| Rate for Payer: Aetna Commercial |
$306.50
|
| Rate for Payer: Aetna Commercial |
$306.50
|
| Rate for Payer: Aetna Medicare |
$228.73
|
| Rate for Payer: Aetna Medicare |
$228.73
|
| Rate for Payer: BCBS MAPPO |
$228.73
|
| Rate for Payer: BCBS MAPPO |
$228.73
|
| Rate for Payer: BCN Commercial |
$322.19
|
| Rate for Payer: BCN Commercial |
$322.19
|
| Rate for Payer: BCN Medicare Advantage |
$228.73
|
| Rate for Payer: BCN Medicare Advantage |
$228.73
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$329.37
|
| Rate for Payer: Cofinity Commercial |
$306.50
|
| Rate for Payer: Cofinity Commercial |
$329.37
|
| Rate for Payer: Cofinity Commercial |
$306.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.73
|
| Rate for Payer: Healthscope Commercial |
$274.48
|
| Rate for Payer: Healthscope Commercial |
$274.48
|
| Rate for Payer: Healthscope Whirlpool |
$274.48
|
| Rate for Payer: Healthscope Whirlpool |
$274.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$251.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$251.60
|
| Rate for Payer: Nomi Health Commercial |
$274.48
|
| Rate for Payer: Nomi Health Commercial |
$274.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.00
|
| Rate for Payer: PACE SWMI |
$228.73
|
| Rate for Payer: PACE SWMI |
$228.73
|
| Rate for Payer: PHP Medicare Advantage |
$228.73
|
| Rate for Payer: PHP Medicare Advantage |
$228.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$297.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$297.13
|
| Rate for Payer: Priority Health Medicare |
$228.73
|
| Rate for Payer: Priority Health Medicare |
$228.73
|
| Rate for Payer: Priority Health Narrow Network |
$297.13
|
| Rate for Payer: Priority Health Narrow Network |
$297.13
|
| Rate for Payer: Railroad Medicare Medicare |
$228.73
|
| Rate for Payer: Railroad Medicare Medicare |
$228.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$228.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$228.73
|
| Rate for Payer: UHC Exchange |
$309.75
|
| Rate for Payer: UHC Exchange |
$309.75
|
| Rate for Payer: UHCCP DNSP |
$228.73
|
| Rate for Payer: UHCCP DNSP |
$228.73
|
|
|
PR ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ
|
Professional
|
Both
|
$6,719.00
|
|
|
Service Code
|
HCPCS 43287
|
| Min. Negotiated Rate |
$2,100.61 |
| Max. Negotiated Rate |
$6,417.38 |
| Rate for Payer: Aetna Commercial |
$4,419.37
|
| Rate for Payer: Aetna Medicare |
$3,298.04
|
| Rate for Payer: BCBS Complete |
$2,205.64
|
| Rate for Payer: BCBS MAPPO |
$3,298.04
|
| Rate for Payer: BCN Commercial |
$5,243.25
|
| Rate for Payer: BCN Medicare Advantage |
$3,298.04
|
| Rate for Payer: Cash Price |
$5,375.20
|
| Rate for Payer: Cash Price |
$5,375.20
|
| Rate for Payer: Cofinity Commercial |
$4,749.18
|
| Rate for Payer: Cofinity Commercial |
$4,419.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,298.04
|
| Rate for Payer: Healthscope Commercial |
$3,957.65
|
| Rate for Payer: Healthscope Whirlpool |
$3,957.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,462.94
|
| Rate for Payer: Meridian Medicaid |
$2,205.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,627.84
|
| Rate for Payer: Nomi Health Commercial |
$3,957.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,039.25
|
| Rate for Payer: PACE SWMI |
$3,298.04
|
| Rate for Payer: PHP Medicare Advantage |
$3,298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,100.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,388.54
|
| Rate for Payer: Priority Health Medicare |
$3,298.04
|
| Rate for Payer: Priority Health Narrow Network |
$6,388.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,417.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,298.04
|
| Rate for Payer: UHC Exchange |
$6,417.38
|
| Rate for Payer: UHC Medicaid |
$2,100.61
|
| Rate for Payer: UHCCP DNSP |
$3,298.04
|
| Rate for Payer: UHCCP Medicaid |
$2,100.61
|
|
|
PR ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ
|
Professional
|
Both
|
$6,803.00
|
|
|
Service Code
|
HCPCS 43286
|
| Min. Negotiated Rate |
$1,878.23 |
| Max. Negotiated Rate |
$5,749.63 |
| Rate for Payer: Aetna Commercial |
$3,944.71
|
| Rate for Payer: Aetna Medicare |
$2,943.81
|
| Rate for Payer: BCBS Complete |
$1,972.14
|
| Rate for Payer: BCBS MAPPO |
$2,943.81
|
| Rate for Payer: BCN Commercial |
$4,718.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,943.81
|
| Rate for Payer: Cash Price |
$5,442.40
|
| Rate for Payer: Cash Price |
$5,442.40
|
| Rate for Payer: Cofinity Commercial |
$4,239.09
|
| Rate for Payer: Cofinity Commercial |
$3,944.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,943.81
|
| Rate for Payer: Healthscope Commercial |
$3,532.57
|
| Rate for Payer: Healthscope Whirlpool |
$3,532.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,091.00
|
| Rate for Payer: Meridian Medicaid |
$1,972.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,238.19
|
| Rate for Payer: Nomi Health Commercial |
$3,532.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,102.25
|
| Rate for Payer: PACE SWMI |
$2,943.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,943.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,878.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5,749.63
|
| Rate for Payer: Priority Health Medicare |
$2,943.81
|
| Rate for Payer: Priority Health Narrow Network |
$5,749.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,943.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5,660.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,943.81
|
| Rate for Payer: UHC Exchange |
$5,660.59
|
| Rate for Payer: UHC Medicaid |
$1,878.23
|
| Rate for Payer: UHCCP DNSP |
$2,943.81
|
| Rate for Payer: UHCCP Medicaid |
$1,878.23
|
|
|
PR ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ
|
Professional
|
Both
|
$6,682.00
|
|
|
Service Code
|
HCPCS 43288
|
| Min. Negotiated Rate |
$2,208.81 |
| Max. Negotiated Rate |
$6,744.72 |
| Rate for Payer: Aetna Commercial |
$4,648.73
|
| Rate for Payer: Aetna Medicare |
$3,469.20
|
| Rate for Payer: BCBS Complete |
$2,319.25
|
| Rate for Payer: BCBS MAPPO |
$3,469.20
|
| Rate for Payer: BCN Commercial |
$5,535.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,469.20
|
| Rate for Payer: Cash Price |
$5,345.60
|
| Rate for Payer: Cash Price |
$5,345.60
|
| Rate for Payer: Cofinity Commercial |
$4,995.65
|
| Rate for Payer: Cofinity Commercial |
$4,648.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,469.20
|
| Rate for Payer: Healthscope Commercial |
$4,163.04
|
| Rate for Payer: Healthscope Whirlpool |
$4,163.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,642.66
|
| Rate for Payer: Meridian Medicaid |
$2,319.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,816.12
|
| Rate for Payer: Nomi Health Commercial |
$4,163.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,011.50
|
| Rate for Payer: PACE SWMI |
$3,469.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,469.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,208.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,744.72
|
| Rate for Payer: Priority Health Medicare |
$3,469.20
|
| Rate for Payer: Priority Health Narrow Network |
$6,744.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3,469.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,743.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,469.20
|
| Rate for Payer: UHC Exchange |
$6,743.04
|
| Rate for Payer: UHC Medicaid |
$2,208.81
|
| Rate for Payer: UHCCP DNSP |
$3,469.20
|
| Rate for Payer: UHCCP Medicaid |
$2,208.81
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION
|
Professional
|
Both
|
$695.00
|
|
|
Service Code
|
HCPCS 43236
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$521.25 |
| Rate for Payer: Aetna Commercial |
$162.88
|
| Rate for Payer: Aetna Medicare |
$121.55
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$121.55
|
| Rate for Payer: BCN Commercial |
$204.18
|
| Rate for Payer: BCN Medicare Advantage |
$121.55
|
| Rate for Payer: Cash Price |
$556.00
|
| Rate for Payer: Cash Price |
$556.00
|
| Rate for Payer: Cofinity Commercial |
$175.03
|
| Rate for Payer: Cofinity Commercial |
$162.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.55
|
| Rate for Payer: Healthscope Commercial |
$145.86
|
| Rate for Payer: Healthscope Whirlpool |
$145.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.63
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$145.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$521.25
|
| Rate for Payer: PACE SWMI |
$121.55
|
| Rate for Payer: PHP Medicare Advantage |
$121.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.77
|
| Rate for Payer: Priority Health Medicare |
$121.55
|
| Rate for Payer: Priority Health Narrow Network |
$248.77
|
| Rate for Payer: Railroad Medicare Medicare |
$121.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.55
|
| Rate for Payer: UHC Exchange |
$243.44
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP DNSP |
$121.55
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
