|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$469.95 |
| Max. Negotiated Rate |
$723.00 |
| Rate for Payer: Aetna Commercial |
$650.70
|
| Rate for Payer: ASR ASR |
$701.31
|
| Rate for Payer: ASR Commercial |
$701.31
|
| Rate for Payer: BCBS Trust/PPO |
$589.17
|
| Rate for Payer: BCN Commercial |
$560.54
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$679.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.40
|
| Rate for Payer: Healthscope Commercial |
$723.00
|
| Rate for Payer: Healthscope Whirlpool |
$701.31
|
| Rate for Payer: Mclaren Commercial |
$650.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.55
|
| Rate for Payer: Nomi Health Commercial |
$592.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.24
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 43235
|
| Hospital Charge Code |
43235
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$469.95 |
| Max. Negotiated Rate |
$1,423.83 |
| Rate for Payer: Aetna Commercial |
$650.70
|
| Rate for Payer: Aetna Medicare |
$918.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: ASR ASR |
$701.31
|
| Rate for Payer: ASR Commercial |
$701.31
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$592.06
|
| Rate for Payer: BCN Commercial |
$560.54
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cofinity Commercial |
$679.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$723.00
|
| Rate for Payer: Healthscope Whirlpool |
$701.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$918.60
|
| Rate for Payer: Mclaren Commercial |
$650.70
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.55
|
| Rate for Payer: Nomi Health Commercial |
$592.86
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,010.46
|
| Rate for Payer: PHP Medicaid |
$492.37
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$633.49
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$506.82
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$636.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$1,423.83
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP DNSP |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: VA VA |
$918.60
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$723.00
|
|
|
Service Code
|
HCPCS 43235
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$469.95 |
| Rate for Payer: Aetna Commercial |
$162.76
|
| Rate for Payer: Aetna Medicare |
$361.50
|
| Rate for Payer: BCBS Complete |
$81.64
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$423.20
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Meridian Medicaid |
$81.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.56
|
| Rate for Payer: Priority Health Narrow Network |
$216.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.16
|
| Rate for Payer: UHC Exchange |
$182.16
|
| Rate for Payer: UHCCP Medicaid |
$77.75
|
|
|
PR ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 43237
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$598.00 |
| Rate for Payer: Aetna Commercial |
$259.91
|
| Rate for Payer: Aetna Medicare |
$460.00
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$280.50
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.24
|
| Rate for Payer: Priority Health Narrow Network |
$344.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.75
|
| Rate for Payer: UHC Exchange |
$296.75
|
| Rate for Payer: UHCCP Medicaid |
$123.11
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH
|
Professional
|
Both
|
$2,367.00
|
|
|
Service Code
|
HCPCS 43330
|
| Min. Negotiated Rate |
$859.03 |
| Max. Negotiated Rate |
$2,635.16 |
| Rate for Payer: Aetna Commercial |
$1,808.99
|
| Rate for Payer: Aetna Medicare |
$1,183.50
|
| Rate for Payer: BCBS Complete |
$901.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.16
|
| Rate for Payer: BCN Commercial |
$1,950.32
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Meridian Medicaid |
$901.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$859.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,392.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,392.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,604.56
|
| Rate for Payer: UHC Exchange |
$1,604.56
|
| Rate for Payer: UHCCP Medicaid |
$859.03
|
|
|
PR ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH
|
Professional
|
Both
|
$3,191.00
|
|
|
Service Code
|
HCPCS 43331
|
| Min. Negotiated Rate |
$648.75 |
| Max. Negotiated Rate |
$2,372.65 |
| Rate for Payer: Aetna Commercial |
$1,798.83
|
| Rate for Payer: Aetna Medicare |
$1,595.50
|
| Rate for Payer: BCBS Complete |
$893.26
|
| Rate for Payer: BCBS Trust/PPO |
$648.75
|
| Rate for Payer: BCN Commercial |
$1,933.69
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Cash Price |
$2,552.80
|
| Rate for Payer: Meridian Medicaid |
$893.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,074.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,372.65
|
| Rate for Payer: Priority Health Narrow Network |
$2,372.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,720.84
|
| Rate for Payer: UHC Exchange |
$1,720.84
|
| Rate for Payer: UHCCP Medicaid |
$850.72
|
|
|
PR ESOPHAGOSCOPY,ABLATION TUMOR
|
Professional
|
Both
|
$1,440.00
|
|
|
Service Code
|
HCPCS 43228
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$936.00 |
| Rate for Payer: Aetna Medicare |
$720.00
|
| Rate for Payer: BCBS Complete |
$576.00
|
| Rate for Payer: Cash Price |
$1,152.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$936.00
|
|
|
PR ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 43214
|
| Min. Negotiated Rate |
$123.97 |
| Max. Negotiated Rate |
$343.04 |
| Rate for Payer: Aetna Commercial |
$256.38
|
| Rate for Payer: Aetna Medicare |
$201.50
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS Trust/PPO |
$167.47
|
| Rate for Payer: BCN Commercial |
$280.02
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$343.04
|
| Rate for Payer: Priority Health Narrow Network |
$343.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.45
|
| Rate for Payer: UHC Exchange |
$260.45
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 43220
|
| Min. Negotiated Rate |
$68.34 |
| Max. Negotiated Rate |
$1,333.11 |
| Rate for Payer: Aetna Commercial |
$156.84
|
| Rate for Payer: Aetna Medicare |
$759.00
|
| Rate for Payer: BCBS Complete |
$78.95
|
| Rate for Payer: BCBS Trust/PPO |
$68.34
|
| Rate for Payer: BCN Commercial |
$1,333.11
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Meridian Medicaid |
$78.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$986.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.81
|
| Rate for Payer: Priority Health Narrow Network |
$208.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$158.83
|
| Rate for Payer: UHC Exchange |
$158.83
|
| Rate for Payer: UHCCP Medicaid |
$75.19
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43226
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$569.31 |
| Rate for Payer: Aetna Commercial |
$173.52
|
| Rate for Payer: Aetna Medicare |
$394.50
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS Trust/PPO |
$127.32
|
| Rate for Payer: BCN Commercial |
$569.31
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$230.88
|
| Rate for Payer: Priority Health Narrow Network |
$230.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$177.64
|
| Rate for Payer: UHC Exchange |
$177.64
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 43215
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$684.45 |
| Rate for Payer: Aetna Commercial |
$187.69
|
| Rate for Payer: Aetna Medicare |
$526.50
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.79
|
| Rate for Payer: UHC Exchange |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$89.89
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$1,053.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$684.45 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$947.70
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$1,021.41
|
| Rate for Payer: ASR Commercial |
$1,021.41
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$862.30
|
| Rate for Payer: BCN Commercial |
$816.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$989.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,053.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,021.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$947.70
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$863.46
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$922.64
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$738.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$926.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Facility
|
IP
|
$1,053.00
|
|
|
Service Code
|
CPT 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$684.45 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$947.70
|
| Rate for Payer: ASR ASR |
$1,021.41
|
| Rate for Payer: ASR Commercial |
$1,021.41
|
| Rate for Payer: BCBS Trust/PPO |
$858.09
|
| Rate for Payer: BCN Commercial |
$816.39
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$989.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Healthscope Commercial |
$1,053.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,021.41
|
| Rate for Payer: Mclaren Commercial |
$947.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$863.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$926.64
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 43215
|
| Hospital Charge Code |
43215
|
| Min. Negotiated Rate |
$89.89 |
| Max. Negotiated Rate |
$684.45 |
| Rate for Payer: Aetna Commercial |
$187.69
|
| Rate for Payer: Aetna Medicare |
$526.50
|
| Rate for Payer: BCBS Complete |
$94.38
|
| Rate for Payer: BCBS Trust/PPO |
$162.19
|
| Rate for Payer: BCN Commercial |
$579.09
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Meridian Medicaid |
$94.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.96
|
| Rate for Payer: Priority Health Narrow Network |
$249.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.79
|
| Rate for Payer: UHC Exchange |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$89.89
|
|
|
PR ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE
|
Professional
|
Both
|
$1,170.00
|
|
|
Service Code
|
HCPCS 43217
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$760.50 |
| Rate for Payer: Aetna Commercial |
$212.68
|
| Rate for Payer: Aetna Medicare |
$585.00
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$618.18
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$760.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.19
|
| Rate for Payer: Priority Health Narrow Network |
$282.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.15
|
| Rate for Payer: UHC Exchange |
$214.15
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC
|
Professional
|
Both
|
$403.00
|
|
|
Service Code
|
HCPCS 43200
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$388.99 |
| Rate for Payer: Aetna Commercial |
$116.05
|
| Rate for Payer: Aetna Medicare |
$201.50
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$388.99
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Cash Price |
$322.40
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.30
|
| Rate for Payer: Priority Health Narrow Network |
$156.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.21
|
| Rate for Payer: UHC Exchange |
$129.21
|
| Rate for Payer: UHCCP Medicaid |
$55.81
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM
|
Professional
|
Both
|
$884.00
|
|
|
Service Code
|
HCPCS 43231
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$574.60 |
| Rate for Payer: Aetna Commercial |
$211.32
|
| Rate for Payer: Aetna Medicare |
$442.00
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS Trust/PPO |
$176.98
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Cash Price |
$707.20
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.81
|
| Rate for Payer: Priority Health Narrow Network |
$276.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.44
|
| Rate for Payer: UHC Exchange |
$239.44
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$512.85 |
| Max. Negotiated Rate |
$789.00 |
| Rate for Payer: Aetna Commercial |
$710.10
|
| Rate for Payer: ASR ASR |
$765.33
|
| Rate for Payer: ASR Commercial |
$765.33
|
| Rate for Payer: BCBS Trust/PPO |
$642.96
|
| Rate for Payer: BCN Commercial |
$611.71
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$741.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.20
|
| Rate for Payer: Healthscope Commercial |
$789.00
|
| Rate for Payer: Healthscope Whirlpool |
$765.33
|
| Rate for Payer: Mclaren Commercial |
$710.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.65
|
| Rate for Payer: Nomi Health Commercial |
$646.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.32
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$526.80 |
| Rate for Payer: Aetna Commercial |
$136.23
|
| Rate for Payer: Aetna Medicare |
$394.50
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.56
|
| Rate for Payer: Priority Health Narrow Network |
$182.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.71
|
| Rate for Payer: UHC Exchange |
$143.71
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
CPT 43202
|
| Hospital Charge Code |
43202
|
| Min. Negotiated Rate |
$512.85 |
| Max. Negotiated Rate |
$2,880.88 |
| Rate for Payer: Aetna Commercial |
$710.10
|
| Rate for Payer: Aetna Medicare |
$1,858.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: ASR ASR |
$765.33
|
| Rate for Payer: ASR Commercial |
$765.33
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$646.11
|
| Rate for Payer: BCN Commercial |
$611.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cofinity Commercial |
$741.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$789.00
|
| Rate for Payer: Healthscope Whirlpool |
$765.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,858.63
|
| Rate for Payer: Mclaren Commercial |
$710.10
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.65
|
| Rate for Payer: Nomi Health Commercial |
$646.98
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$2,044.49
|
| Rate for Payer: PHP Medicaid |
$996.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.32
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$553.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$2,880.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP DNSP |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: VA VA |
$1,858.63
|
|
|
PR ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY
|
Professional
|
Both
|
$789.00
|
|
|
Service Code
|
HCPCS 43202
|
| Min. Negotiated Rate |
$31.17 |
| Max. Negotiated Rate |
$526.80 |
| Rate for Payer: Aetna Commercial |
$136.23
|
| Rate for Payer: Aetna Medicare |
$394.50
|
| Rate for Payer: BCBS Complete |
$68.44
|
| Rate for Payer: BCBS Trust/PPO |
$31.17
|
| Rate for Payer: BCN Commercial |
$526.80
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Cash Price |
$631.20
|
| Rate for Payer: Meridian Medicaid |
$68.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.56
|
| Rate for Payer: Priority Health Narrow Network |
$182.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.71
|
| Rate for Payer: UHC Exchange |
$143.71
|
| Rate for Payer: UHCCP Medicaid |
$65.18
|
|
|
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 |
$136.26
|
| Rate for Payer: Aetna Medicare |
$247.50
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS Trust/PPO |
$30.11
|
| Rate for Payer: BCN Commercial |
$383.13
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| 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 Narrow Network |
$183.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$161.41
|
| Rate for Payer: UHC Exchange |
$161.41
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
|
|
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 |
$219.16
|
| Rate for Payer: Aetna Medicare |
$552.00
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS Trust/PPO |
$43.32
|
| Rate for Payer: BCN Commercial |
$876.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| 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 Narrow Network |
$291.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.36
|
| Rate for Payer: UHC Exchange |
$264.36
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
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 |
$179.22
|
| Rate for Payer: Aetna Medicare |
$552.00
|
| Rate for Payer: BCBS Complete |
$89.91
|
| Rate for Payer: BCBS Trust/PPO |
$249.36
|
| Rate for Payer: BCN Commercial |
$194.01
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Meridian Medicaid |
$89.91
|
| 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 Narrow Network |
$238.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$281.23
|
| Rate for Payer: UHC Exchange |
$281.23
|
| Rate for Payer: UHCCP Medicaid |
$85.63
|
|
|
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 |
$262.30
|
| Rate for Payer: Aetna Medicare |
$319.50
|
| Rate for Payer: BCBS Complete |
$130.17
|
| Rate for Payer: BCBS Trust/PPO |
$123.53
|
| Rate for Payer: BCN Commercial |
$1,048.21
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Cash Price |
$511.20
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| 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 Narrow Network |
$346.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.25
|
| Rate for Payer: UHC Exchange |
$275.25
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
