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CPT 91040

PR ESOPHGL BALO DISTENSION DX STD W/PROVOCATION

Reported by 385 hospitals in the network under the fee schedule methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$1

Average

$950

Median

$838

High

$4.5k

Hospitals reporting this code

#HospitalLocation
1The Finley HospitalDubuque, IA$44$464$615$2.0k$425
2Northwest Iowa Hospital CorporationSioux City, IA$44$461$599$1.4k$433
3St Luke'sJones Regional Medical CenterAnamosa, IA$44$439$546$1.3k$415
4Medical Ctiy ArgyleArgyle, TX$1.0k$2.1k$1.9k$2.7k$596
5Medical City AllianceSAGINAW, TX$1.0k$2.1k$1.9k$2.7k$596
6St Luke's Methodist HospitalCedar Rapids, IA$44$461$599$1.3k$425
7Trinity Medical CenterRock Island, IL$44$448$616$2.0k$454
8Trinity Medical CenterBettendorf, IA$44$457$588$1.4k$432
9University of Iowa Health Care Medical Center DowntownIowa City, IA$71$886$1.1k$2.5k$587
10Unity HealthcareMuscatine, IA$44$458$618$2.0k$460
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