|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 43235
|
| Hospital Charge Code |
43235
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$558.75 |
| Rate for Payer: Aetna Commercial |
$145.52
|
| Rate for Payer: Aetna Medicare |
$108.60
|
| Rate for Payer: BCBS Complete |
$74.03
|
| Rate for Payer: BCBS MAPPO |
$108.60
|
| Rate for Payer: BCN Commercial |
$181.76
|
| Rate for Payer: BCN Medicare Advantage |
$108.60
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$156.38
|
| Rate for Payer: Cofinity Commercial |
$145.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.60
|
| Rate for Payer: Healthscope Commercial |
$130.32
|
| Rate for Payer: Healthscope Whirlpool |
$130.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.03
|
| Rate for Payer: Meridian Medicaid |
$74.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.46
|
| Rate for Payer: Nomi Health Commercial |
$130.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$558.75
|
| Rate for Payer: PACE SWMI |
$108.60
|
| Rate for Payer: PHP Medicare Advantage |
$108.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$221.46
|
| Rate for Payer: Priority Health Medicare |
$108.60
|
| Rate for Payer: Priority Health Narrow Network |
$221.46
|
| Rate for Payer: Railroad Medicare Medicare |
$108.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.60
|
| Rate for Payer: UHC Exchange |
$215.93
|
| Rate for Payer: UHC Medicaid |
$70.50
|
| Rate for Payer: UHCCP DNSP |
$108.60
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$558.75 |
| Max. Negotiated Rate |
$745.00 |
| Rate for Payer: Aetna Commercial |
$670.50
|
| Rate for Payer: ASR ASR |
$722.65
|
| Rate for Payer: BCBS Trust/PPO |
$611.79
|
| Rate for Payer: BCN Commercial |
$611.79
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$700.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$722.65
|
| Rate for Payer: Healthscope Whirlpool |
$745.00
|
| Rate for Payer: Mclaren Commercial |
$670.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$610.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$558.75
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 43235
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$558.75 |
| Rate for Payer: Aetna Commercial |
$145.52
|
| Rate for Payer: Aetna Medicare |
$108.60
|
| Rate for Payer: BCBS Complete |
$74.03
|
| Rate for Payer: BCBS MAPPO |
$108.60
|
| Rate for Payer: BCN Commercial |
$181.76
|
| Rate for Payer: BCN Medicare Advantage |
$108.60
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$156.38
|
| Rate for Payer: Cofinity Commercial |
$145.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.60
|
| Rate for Payer: Healthscope Commercial |
$130.32
|
| Rate for Payer: Healthscope Whirlpool |
$130.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.03
|
| Rate for Payer: Meridian Medicaid |
$74.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.46
|
| Rate for Payer: Nomi Health Commercial |
$130.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$558.75
|
| Rate for Payer: PACE SWMI |
$108.60
|
| Rate for Payer: PHP Medicare Advantage |
$108.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$221.46
|
| Rate for Payer: Priority Health Medicare |
$108.60
|
| Rate for Payer: Priority Health Narrow Network |
$221.46
|
| Rate for Payer: Railroad Medicare Medicare |
$108.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$215.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.60
|
| Rate for Payer: UHC Exchange |
$215.93
|
| Rate for Payer: UHC Medicaid |
$70.50
|
| Rate for Payer: UHCCP DNSP |
$108.60
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,129.65 |
| Rate for Payer: Aetna Commercial |
$670.50
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$722.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$614.25
|
| Rate for Payer: BCN Commercial |
$614.25
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$700.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$722.65
|
| Rate for Payer: Healthscope Whirlpool |
$745.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$670.50
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: Nomi Health Commercial |
$610.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$558.75
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$652.77
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$522.25
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 43237
|
| Min. Negotiated Rate |
$110.33 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna Commercial |
$228.51
|
| Rate for Payer: Aetna Medicare |
$170.53
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS MAPPO |
$170.53
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$170.53
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$245.56
|
| Rate for Payer: Cofinity Commercial |
$228.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.53
|
| Rate for Payer: Healthscope Commercial |
$204.64
|
| Rate for Payer: Healthscope Whirlpool |
$204.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.06
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.58
|
| Rate for Payer: Nomi Health Commercial |
$204.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.00
|
| Rate for Payer: PACE SWMI |
$170.53
|
| Rate for Payer: PHP Medicare Advantage |
$170.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$350.70
|
| Rate for Payer: Priority Health Medicare |
$170.53
|
| Rate for Payer: Priority Health Narrow Network |
$350.70
|
| Rate for Payer: Railroad Medicare Medicare |
$170.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$344.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.53
|
| Rate for Payer: UHC Exchange |
$344.54
|
| Rate for Payer: UHC Medicaid |
$110.33
|
| Rate for Payer: UHCCP DNSP |
$170.53
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,438.00
|
|
|
Service Code
|
HCPCS 43330
|
| Min. Negotiated Rate |
$798.54 |
| Max. Negotiated Rate |
$2,447.04 |
| Rate for Payer: Aetna Commercial |
$1,672.01
|
| Rate for Payer: Aetna Medicare |
$1,247.77
|
| Rate for Payer: BCBS Complete |
$838.47
|
| Rate for Payer: BCBS MAPPO |
$1,247.77
|
| Rate for Payer: BCN Commercial |
$2,008.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,247.77
|
| Rate for Payer: Cash Price |
$1,950.40
|
| Rate for Payer: Cash Price |
$1,950.40
|
| Rate for Payer: Cofinity Commercial |
$1,796.79
|
| Rate for Payer: Cofinity Commercial |
$1,672.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,247.77
|
| Rate for Payer: Healthscope Commercial |
$1,497.32
|
| Rate for Payer: Healthscope Whirlpool |
$1,497.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,310.16
|
| Rate for Payer: Meridian Medicaid |
$838.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,372.55
|
| Rate for Payer: Nomi Health Commercial |
$1,497.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,828.50
|
| Rate for Payer: PACE SWMI |
$1,247.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,247.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$798.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,447.04
|
| Rate for Payer: Priority Health Medicare |
$1,247.77
|
| Rate for Payer: Priority Health Narrow Network |
$2,447.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,247.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,385.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,247.77
|
| Rate for Payer: UHC Exchange |
$2,385.45
|
| Rate for Payer: UHC Medicaid |
$798.54
|
| Rate for Payer: UHCCP DNSP |
$1,247.77
|
| Rate for Payer: UHCCP Medicaid |
$798.54
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH
|
Professional
|
Both
|
$3,287.00
|
|
|
Service Code
|
HCPCS 43331
|
| Min. Negotiated Rate |
$817.71 |
| Max. Negotiated Rate |
$2,465.25 |
| Rate for Payer: Aetna Commercial |
$1,710.99
|
| Rate for Payer: Aetna Medicare |
$1,276.86
|
| Rate for Payer: BCBS Complete |
$858.60
|
| Rate for Payer: BCBS MAPPO |
$1,276.86
|
| Rate for Payer: BCN Commercial |
$1,988.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.86
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Cash Price |
$2,629.60
|
| Rate for Payer: Cofinity Commercial |
$1,838.68
|
| Rate for Payer: Cofinity Commercial |
$1,710.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.86
|
| Rate for Payer: Healthscope Commercial |
$1,532.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,532.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,340.70
|
| Rate for Payer: Meridian Medicaid |
$858.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,404.55
|
| Rate for Payer: Nomi Health Commercial |
$1,532.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,465.25
|
| Rate for Payer: PACE SWMI |
$1,276.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$817.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,423.39
|
| Rate for Payer: Priority Health Medicare |
$1,276.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,423.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,276.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,377.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,276.86
|
| Rate for Payer: UHC Exchange |
$2,377.92
|
| Rate for Payer: UHC Medicaid |
$817.71
|
| Rate for Payer: UHCCP DNSP |
$1,276.86
|
| Rate for Payer: UHCCP Medicaid |
$817.71
|
|
|
PR ESOPHAGOSCOPY,ABLATION TUMOR
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 43228
|
| Min. Negotiated Rate |
$593.20 |
| Max. Negotiated Rate |
$1,112.25 |
| Rate for Payer: BCBS Complete |
$593.20
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,112.25
|
|
|
PR ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 43214
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$353.14 |
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: Aetna Medicare |
$166.95
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$166.95
|
| Rate for Payer: BCN Commercial |
$289.82
|
| Rate for Payer: BCN Medicare Advantage |
$166.95
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$223.71
|
| Rate for Payer: Cofinity Commercial |
$240.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.95
|
| Rate for Payer: Healthscope Commercial |
$200.34
|
| Rate for Payer: Healthscope Whirlpool |
$200.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.30
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.65
|
| Rate for Payer: Nomi Health Commercial |
$200.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$311.25
|
| Rate for Payer: PACE SWMI |
$166.95
|
| Rate for Payer: PHP Medicare Advantage |
$166.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$353.14
|
| Rate for Payer: Priority Health Medicare |
$166.95
|
| Rate for Payer: Priority Health Narrow Network |
$353.14
|
| Rate for Payer: Railroad Medicare Medicare |
$166.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.95
|
| Rate for Payer: UHC Exchange |
$339.79
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP DNSP |
$166.95
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM
|
Professional
|
Both
|
$1,564.00
|
|
|
Service Code
|
HCPCS 43220
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$1,173.00 |
| Rate for Payer: Aetna Commercial |
$139.64
|
| Rate for Payer: Aetna Medicare |
$104.21
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$104.21
|
| Rate for Payer: BCN Commercial |
$175.79
|
| Rate for Payer: BCN Medicare Advantage |
$104.21
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cash Price |
$1,251.20
|
| Rate for Payer: Cofinity Commercial |
$150.06
|
| Rate for Payer: Cofinity Commercial |
$139.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.21
|
| Rate for Payer: Healthscope Commercial |
$125.05
|
| Rate for Payer: Healthscope Whirlpool |
$125.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.42
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.63
|
| Rate for Payer: Nomi Health Commercial |
$125.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,173.00
|
| Rate for Payer: PACE SWMI |
$104.21
|
| Rate for Payer: PHP Medicare Advantage |
$104.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.18
|
| Rate for Payer: Priority Health Medicare |
$104.21
|
| Rate for Payer: Priority Health Narrow Network |
$214.18
|
| Rate for Payer: Railroad Medicare Medicare |
$104.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.21
|
| Rate for Payer: UHC Exchange |
$207.41
|
| Rate for Payer: UHC Medicaid |
$67.52
|
| Rate for Payer: UHCCP DNSP |
$104.21
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 43226
|
| Min. Negotiated Rate |
$74.76 |
| Max. Negotiated Rate |
$609.75 |
| Rate for Payer: Aetna Commercial |
$155.40
|
| Rate for Payer: Aetna Medicare |
$115.97
|
| Rate for Payer: BCBS Complete |
$78.50
|
| Rate for Payer: BCBS MAPPO |
$115.97
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Medicare Advantage |
$115.97
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$167.00
|
| Rate for Payer: Cofinity Commercial |
$155.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.97
|
| Rate for Payer: Healthscope Commercial |
$139.16
|
| Rate for Payer: Healthscope Whirlpool |
$139.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.77
|
| Rate for Payer: Meridian Medicaid |
$78.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.57
|
| Rate for Payer: Nomi Health Commercial |
$139.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$609.75
|
| Rate for Payer: PACE SWMI |
$115.97
|
| Rate for Payer: PHP Medicare Advantage |
$115.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$237.23
|
| Rate for Payer: Priority Health Medicare |
$115.97
|
| Rate for Payer: Priority Health Narrow Network |
$237.23
|
| Rate for Payer: Railroad Medicare Medicare |
$115.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.97
|
| Rate for Payer: UHC Exchange |
$229.11
|
| Rate for Payer: UHC Medicaid |
$74.76
|
| Rate for Payer: UHCCP DNSP |
$115.97
|
| Rate for Payer: UHCCP Medicaid |
$74.76
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,085.00
|
|
|
Service Code
|
HCPCS 43215
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$813.75 |
| Rate for Payer: Aetna Commercial |
$168.84
|
| Rate for Payer: Aetna Medicare |
$126.00
|
| Rate for Payer: BCBS Complete |
$85.44
|
| Rate for Payer: BCBS MAPPO |
$126.00
|
| Rate for Payer: BCN Commercial |
$210.15
|
| Rate for Payer: BCN Medicare Advantage |
$126.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cofinity Commercial |
$181.44
|
| Rate for Payer: Cofinity Commercial |
$168.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.00
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Healthscope Whirlpool |
$151.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.30
|
| Rate for Payer: Meridian Medicaid |
$85.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.60
|
| Rate for Payer: Nomi Health Commercial |
$151.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$813.75
|
| Rate for Payer: PACE SWMI |
$126.00
|
| Rate for Payer: PHP Medicare Advantage |
$126.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$256.05
|
| Rate for Payer: Priority Health Medicare |
$126.00
|
| Rate for Payer: Priority Health Narrow Network |
$256.05
|
| Rate for Payer: Railroad Medicare Medicare |
$126.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$249.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.00
|
| Rate for Payer: UHC Exchange |
$249.31
|
| Rate for Payer: UHC Medicaid |
$81.37
|
| Rate for Payer: UHCCP DNSP |
$126.00
|
| Rate for Payer: UHCCP Medicaid |
$81.37
|
|
|
PR ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE
|
Professional
|
Both
|
$1,205.00
|
|
|
Service Code
|
HCPCS 43217
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$903.75 |
| Rate for Payer: Aetna Commercial |
$187.61
|
| Rate for Payer: Aetna Medicare |
$140.01
|
| Rate for Payer: BCBS Complete |
$95.28
|
| Rate for Payer: BCBS MAPPO |
$140.01
|
| Rate for Payer: BCN Commercial |
$236.55
|
| Rate for Payer: BCN Medicare Advantage |
$140.01
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Commercial |
$201.61
|
| Rate for Payer: Cofinity Commercial |
$187.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.01
|
| Rate for Payer: Healthscope Commercial |
$168.01
|
| Rate for Payer: Healthscope Whirlpool |
$168.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.01
|
| Rate for Payer: Meridian Medicaid |
$95.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.01
|
| Rate for Payer: Nomi Health Commercial |
$168.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PACE SWMI |
$140.01
|
| Rate for Payer: PHP Medicare Advantage |
$140.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$288.22
|
| Rate for Payer: Priority Health Medicare |
$140.01
|
| Rate for Payer: Priority Health Narrow Network |
$288.22
|
| Rate for Payer: Railroad Medicare Medicare |
$140.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.01
|
| Rate for Payer: UHC Exchange |
$281.98
|
| Rate for Payer: UHC Medicaid |
$90.74
|
| Rate for Payer: UHCCP DNSP |
$140.01
|
| Rate for Payer: UHCCP Medicaid |
$90.74
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 43200
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$311.25 |
| Rate for Payer: Aetna Commercial |
$104.65
|
| Rate for Payer: Aetna Medicare |
$78.10
|
| Rate for Payer: BCBS Complete |
$53.22
|
| Rate for Payer: BCBS MAPPO |
$78.10
|
| Rate for Payer: BCN Commercial |
$130.47
|
| Rate for Payer: BCN Medicare Advantage |
$78.10
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$112.46
|
| Rate for Payer: Cofinity Commercial |
$104.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.10
|
| Rate for Payer: Healthscope Commercial |
$93.72
|
| Rate for Payer: Healthscope Whirlpool |
$93.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.00
|
| Rate for Payer: Meridian Medicaid |
$53.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.91
|
| Rate for Payer: Nomi Health Commercial |
$93.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$311.25
|
| Rate for Payer: PACE SWMI |
$78.10
|
| Rate for Payer: PHP Medicare Advantage |
$78.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$158.97
|
| Rate for Payer: Priority Health Medicare |
$78.10
|
| Rate for Payer: Priority Health Narrow Network |
$158.97
|
| Rate for Payer: Railroad Medicare Medicare |
$78.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$153.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.10
|
| Rate for Payer: UHC Exchange |
$153.49
|
| Rate for Payer: UHC Medicaid |
$50.69
|
| Rate for Payer: UHCCP DNSP |
$78.10
|
| Rate for Payer: UHCCP Medicaid |
$50.69
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM
|
Professional
|
Both
|
$911.00
|
|
|
Service Code
|
HCPCS 43231
|
| Min. Negotiated Rate |
$87.97 |
| Max. Negotiated Rate |
$683.25 |
| Rate for Payer: Aetna Commercial |
$182.01
|
| Rate for Payer: Aetna Medicare |
$135.83
|
| Rate for Payer: BCBS Complete |
$92.37
|
| Rate for Payer: BCBS MAPPO |
$135.83
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: BCN Medicare Advantage |
$135.83
|
| Rate for Payer: Cash Price |
$728.80
|
| Rate for Payer: Cash Price |
$728.80
|
| Rate for Payer: Cofinity Commercial |
$195.60
|
| Rate for Payer: Cofinity Commercial |
$182.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.83
|
| Rate for Payer: Healthscope Commercial |
$163.00
|
| Rate for Payer: Healthscope Whirlpool |
$163.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.62
|
| Rate for Payer: Meridian Medicaid |
$92.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.41
|
| Rate for Payer: Nomi Health Commercial |
$163.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$683.25
|
| Rate for Payer: PACE SWMI |
$135.83
|
| Rate for Payer: PHP Medicare Advantage |
$135.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$279.72
|
| Rate for Payer: Priority Health Medicare |
$135.83
|
| Rate for Payer: Priority Health Narrow Network |
$279.72
|
| Rate for Payer: Railroad Medicare Medicare |
$135.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.83
|
| Rate for Payer: UHC Exchange |
$280.16
|
| Rate for Payer: UHC Medicaid |
$87.97
|
| Rate for Payer: UHCCP DNSP |
$135.83
|
| Rate for Payer: UHCCP Medicaid |
$87.97
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$813.00
|
|
|
Service Code
|
HCPCS 43202
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$609.75 |
| Rate for Payer: Aetna Commercial |
$122.58
|
| Rate for Payer: Aetna Medicare |
$91.48
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$91.48
|
| Rate for Payer: BCN Commercial |
$152.39
|
| Rate for Payer: BCN Medicare Advantage |
$91.48
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cash Price |
$650.40
|
| Rate for Payer: Cofinity Commercial |
$131.73
|
| Rate for Payer: Cofinity Commercial |
$122.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.48
|
| Rate for Payer: Healthscope Commercial |
$109.78
|
| Rate for Payer: Healthscope Whirlpool |
$109.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.05
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.63
|
| Rate for Payer: Nomi Health Commercial |
$109.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$609.75
|
| Rate for Payer: PACE SWMI |
$91.48
|
| Rate for Payer: PHP Medicare Advantage |
$91.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.67
|
| Rate for Payer: Priority Health Medicare |
$91.48
|
| Rate for Payer: Priority Health Narrow Network |
$185.67
|
| Rate for Payer: Railroad Medicare Medicare |
$91.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.48
|
| Rate for Payer: UHC Exchange |
$181.05
|
| Rate for Payer: UHC Medicaid |
$59.43
|
| Rate for Payer: UHCCP DNSP |
$91.48
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 43201
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Aetna Commercial |
$121.46
|
| Rate for Payer: Aetna Medicare |
$90.64
|
| Rate for Payer: BCBS Complete |
$61.73
|
| Rate for Payer: BCBS MAPPO |
$90.64
|
| Rate for Payer: BCN Commercial |
$153.87
|
| Rate for Payer: BCN Medicare Advantage |
$90.64
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$130.52
|
| Rate for Payer: Cofinity Commercial |
$121.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.64
|
| Rate for Payer: Healthscope Commercial |
$108.77
|
| Rate for Payer: Healthscope Whirlpool |
$108.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.17
|
| Rate for Payer: Meridian Medicaid |
$61.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.50
|
| Rate for Payer: PACE SWMI |
$90.64
|
| Rate for Payer: PHP Medicare Advantage |
$90.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$187.49
|
| Rate for Payer: Priority Health Medicare |
$90.64
|
| Rate for Payer: Priority Health Narrow Network |
$187.49
|
| Rate for Payer: Railroad Medicare Medicare |
$90.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.64
|
| Rate for Payer: UHC Exchange |
$181.67
|
| Rate for Payer: UHC Medicaid |
$58.79
|
| Rate for Payer: UHCCP DNSP |
$90.64
|
| Rate for Payer: UHCCP Medicaid |
$58.79
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 43227
|
| Min. Negotiated Rate |
$93.72 |
| Max. Negotiated Rate |
$852.75 |
| Rate for Payer: Aetna Commercial |
$194.26
|
| Rate for Payer: Aetna Medicare |
$144.97
|
| Rate for Payer: BCBS Complete |
$98.41
|
| Rate for Payer: BCBS MAPPO |
$144.97
|
| Rate for Payer: BCN Commercial |
$243.51
|
| Rate for Payer: BCN Medicare Advantage |
$144.97
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$208.76
|
| Rate for Payer: Cofinity Commercial |
$194.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.97
|
| Rate for Payer: Healthscope Commercial |
$173.96
|
| Rate for Payer: Healthscope Whirlpool |
$173.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.22
|
| Rate for Payer: Meridian Medicaid |
$98.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.47
|
| Rate for Payer: Nomi Health Commercial |
$173.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.75
|
| Rate for Payer: PACE SWMI |
$144.97
|
| Rate for Payer: PHP Medicare Advantage |
$144.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$296.70
|
| Rate for Payer: Priority Health Medicare |
$144.97
|
| Rate for Payer: Priority Health Narrow Network |
$296.70
|
| Rate for Payer: Railroad Medicare Medicare |
$144.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.97
|
| Rate for Payer: UHC Exchange |
$290.04
|
| Rate for Payer: UHC Medicaid |
$93.72
|
| Rate for Payer: UHCCP DNSP |
$144.97
|
| Rate for Payer: UHCCP Medicaid |
$93.72
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 43204
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$852.75 |
| Rate for Payer: Aetna Commercial |
$158.78
|
| Rate for Payer: Aetna Medicare |
$118.49
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$118.49
|
| Rate for Payer: BCN Commercial |
$200.19
|
| Rate for Payer: BCN Medicare Advantage |
$118.49
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$170.63
|
| Rate for Payer: Cofinity Commercial |
$158.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.49
|
| Rate for Payer: Healthscope Commercial |
$142.19
|
| Rate for Payer: Healthscope Whirlpool |
$142.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.41
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.34
|
| Rate for Payer: Nomi Health Commercial |
$142.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$852.75
|
| Rate for Payer: PACE SWMI |
$118.49
|
| Rate for Payer: PHP Medicare Advantage |
$118.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$243.91
|
| Rate for Payer: Priority Health Medicare |
$118.49
|
| Rate for Payer: Priority Health Narrow Network |
$243.91
|
| Rate for Payer: Railroad Medicare Medicare |
$118.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.49
|
| Rate for Payer: UHC Exchange |
$237.89
|
| Rate for Payer: UHC Medicaid |
$76.89
|
| Rate for Payer: UHCCP DNSP |
$118.49
|
| Rate for Payer: UHCCP Medicaid |
$76.89
|
|
|
PR ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 43229
|
| Min. Negotiated Rate |
$111.40 |
| Max. Negotiated Rate |
$493.50 |
| Rate for Payer: Aetna Commercial |
$230.92
|
| Rate for Payer: Aetna Medicare |
$172.33
|
| Rate for Payer: BCBS Complete |
$116.97
|
| Rate for Payer: BCBS MAPPO |
$172.33
|
| Rate for Payer: BCN Commercial |
$289.82
|
| Rate for Payer: BCN Medicare Advantage |
$172.33
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$230.92
|
| Rate for Payer: Cofinity Commercial |
$248.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.33
|
| Rate for Payer: Healthscope Commercial |
$206.80
|
| Rate for Payer: Healthscope Whirlpool |
$206.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.95
|
| Rate for Payer: Meridian Medicaid |
$116.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.56
|
| Rate for Payer: Nomi Health Commercial |
$206.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.50
|
| Rate for Payer: PACE SWMI |
$172.33
|
| Rate for Payer: PHP Medicare Advantage |
$172.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$353.14
|
| Rate for Payer: Priority Health Medicare |
$172.33
|
| Rate for Payer: Priority Health Narrow Network |
$353.14
|
| Rate for Payer: Railroad Medicare Medicare |
$172.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.33
|
| Rate for Payer: UHC Exchange |
$348.35
|
| Rate for Payer: UHC Medicaid |
$111.40
|
| Rate for Payer: UHCCP DNSP |
$172.33
|
| Rate for Payer: UHCCP Medicaid |
$111.40
|
|
|
PR ESOPHAGOSCOPY,INSERT TUBE/STENT
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 43219
|
| Min. Negotiated Rate |
$616.40 |
| Max. Negotiated Rate |
$1,155.75 |
| Rate for Payer: BCBS Complete |
$616.40
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,155.75
|
|
|
PR ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX
|
Professional
|
Both
|
$1,065.00
|
|
|
Service Code
|
HCPCS 43232
|
| Min. Negotiated Rate |
$113.10 |
| Max. Negotiated Rate |
$798.75 |
| Rate for Payer: Aetna Commercial |
$234.38
|
| Rate for Payer: Aetna Medicare |
$174.91
|
| Rate for Payer: BCBS Complete |
$118.75
|
| Rate for Payer: BCBS MAPPO |
$174.91
|
| Rate for Payer: BCN Commercial |
$291.81
|
| Rate for Payer: BCN Medicare Advantage |
$174.91
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cash Price |
$852.00
|
| Rate for Payer: Cofinity Commercial |
$251.87
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.91
|
| Rate for Payer: Healthscope Commercial |
$209.89
|
| Rate for Payer: Healthscope Whirlpool |
$209.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.66
|
| Rate for Payer: Meridian Medicaid |
$118.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.40
|
| Rate for Payer: Nomi Health Commercial |
$209.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$798.75
|
| Rate for Payer: PACE SWMI |
$174.91
|
| Rate for Payer: PHP Medicare Advantage |
$174.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$355.56
|
| Rate for Payer: Priority Health Medicare |
$174.91
|
| Rate for Payer: Priority Health Narrow Network |
$355.56
|
| Rate for Payer: Railroad Medicare Medicare |
$174.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.91
|
| Rate for Payer: UHC Exchange |
$351.39
|
| Rate for Payer: UHC Medicaid |
$113.10
|
| Rate for Payer: UHCCP DNSP |
$174.91
|
| Rate for Payer: UHCCP Medicaid |
$113.10
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION
|
Professional
|
Both
|
$392.00
|
|
|
Service Code
|
HCPCS 43195
|
| Min. Negotiated Rate |
$101.60 |
| Max. Negotiated Rate |
$339.18 |
| Rate for Payer: Aetna Commercial |
$210.72
|
| Rate for Payer: Aetna Medicare |
$157.25
|
| Rate for Payer: BCBS Complete |
$106.68
|
| Rate for Payer: BCBS MAPPO |
$157.25
|
| Rate for Payer: BCN Commercial |
$278.37
|
| Rate for Payer: BCN Medicare Advantage |
$157.25
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cash Price |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$226.44
|
| Rate for Payer: Cofinity Commercial |
$210.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.25
|
| Rate for Payer: Healthscope Commercial |
$188.70
|
| Rate for Payer: Healthscope Whirlpool |
$188.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.11
|
| Rate for Payer: Meridian Medicaid |
$106.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.97
|
| Rate for Payer: Nomi Health Commercial |
$188.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.00
|
| Rate for Payer: PACE SWMI |
$157.25
|
| Rate for Payer: PHP Medicare Advantage |
$157.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$339.18
|
| Rate for Payer: Priority Health Medicare |
$157.25
|
| Rate for Payer: Priority Health Narrow Network |
$339.18
|
| Rate for Payer: Railroad Medicare Medicare |
$157.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.25
|
| Rate for Payer: UHC Exchange |
$322.04
|
| Rate for Payer: UHC Medicaid |
$101.60
|
| Rate for Payer: UHCCP DNSP |
$157.25
|
| Rate for Payer: UHCCP Medicaid |
$101.60
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 43191
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Aetna Commercial |
$178.94
|
| Rate for Payer: Aetna Medicare |
$133.54
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$133.54
|
| Rate for Payer: BCN Commercial |
$234.05
|
| Rate for Payer: BCN Medicare Advantage |
$133.54
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cofinity Commercial |
$192.30
|
| Rate for Payer: Cofinity Commercial |
$178.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.54
|
| Rate for Payer: Healthscope Commercial |
$160.25
|
| Rate for Payer: Healthscope Whirlpool |
$160.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.22
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.89
|
| Rate for Payer: Nomi Health Commercial |
$160.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.50
|
| Rate for Payer: PACE SWMI |
$133.54
|
| Rate for Payer: PHP Medicare Advantage |
$133.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$285.18
|
| Rate for Payer: Priority Health Medicare |
$133.54
|
| Rate for Payer: Priority Health Narrow Network |
$285.18
|
| Rate for Payer: Railroad Medicare Medicare |
$133.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.54
|
| Rate for Payer: UHC Exchange |
$269.68
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP DNSP |
$133.54
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 43192
|
| Min. Negotiated Rate |
$93.72 |
| Max. Negotiated Rate |
$310.05 |
| Rate for Payer: Aetna Commercial |
$194.26
|
| Rate for Payer: Aetna Medicare |
$144.97
|
| Rate for Payer: BCBS Complete |
$98.41
|
| Rate for Payer: BCBS MAPPO |
$144.97
|
| Rate for Payer: BCN Commercial |
$254.47
|
| Rate for Payer: BCN Medicare Advantage |
$144.97
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$208.76
|
| Rate for Payer: Cofinity Commercial |
$194.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.97
|
| Rate for Payer: Healthscope Commercial |
$173.96
|
| Rate for Payer: Healthscope Whirlpool |
$173.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.22
|
| Rate for Payer: Meridian Medicaid |
$98.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$159.47
|
| Rate for Payer: Nomi Health Commercial |
$173.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.50
|
| Rate for Payer: PACE SWMI |
$144.97
|
| Rate for Payer: PHP Medicare Advantage |
$144.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$310.05
|
| Rate for Payer: Priority Health Medicare |
$144.97
|
| Rate for Payer: Priority Health Narrow Network |
$310.05
|
| Rate for Payer: Railroad Medicare Medicare |
$144.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.97
|
| Rate for Payer: UHC Exchange |
$296.20
|
| Rate for Payer: UHC Medicaid |
$93.72
|
| Rate for Payer: UHCCP DNSP |
$144.97
|
| Rate for Payer: UHCCP Medicaid |
$93.72
|
|
