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New York rates for HCPCS 43497

Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [POEM])

Facilitymedian $4,467 · 10th–90th $1,175–$10,9650%10%10th90th$4,467$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $3,801.89 / $9,332.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $5,495.41 / $12,882.50
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,318.26 / $50,118.72
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,096.48 / $2,754.23
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $8,317.64 / $19,054.61
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,981.07 / $9,549.93
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $933.25 / $1,096.48