APC CASE-91040

Esophgl Balo Distension Dx Std W/Provocation

Payers reporting APC CASE-91040

Low

$373

Average

$375

Median

$375

High

$378

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#
1	Aetna other · outpatient	2	$372	$373	$2	1%	1–10	$370 – $374
2	Humana other · outpatient	2	$376	$378	$6	1%	—	$370 – $382
3	UnitedHealthcare other · outpatient	2	$372	$373	$2	1%	—	$370 – $374
4	Caresource other · outpatient	1	$377	$377	—	—	—	$377 – $377