43235Facility Fee/EGD$693.03
43236Facility Fee/EGO$993.03
43239Facility Fee/EGO$912.81
43243Facility Fee/EGO$930.75
43245Facility Fee/EGO$945.88
43247Facility Fee/EGO$935.88
43248Facility Fee/EGO$945.88
43249Facility Fee/EGO$945.88
43250Facility Fee/EGO$936.90
43251Facility Fee/EGO$936.90
43255Facility Fee/EGO$933.31
43450Facility Fee/Esophageal Dilation, Unguided Bougie$620.25
43760Facility Fee/Change of Peg/Gastrostomy Tube$912.81
44360Facility Fee/Sm Intestine Endoscopy – Push Enteroscopy$912.81
44361Facility Fee/Sm Intestine Endoscopy – Push w/Bx$750.00
44380Facility Fee/lleoscopy Thru Stoma$599.75
44382Facility Fee / lleoscopy Thru Stoma w/Bx$699.75
44388Facility Fee/Colon Thru Stoma$910.25
44389Facility Fee/Colon Thru Stoma w/Bx$925.63
44392Facility Fee/Colon Thru Stoma w/Polyp Removal, Hot Bx$951.25
44394Facility Fee/Colon Thru Stoma w/Polyp Rem, Not Hot Bx$943.56
44799Unlisted procedure small intestine$300.00
45330Facility Fee/Flexible Sigmoidoscopy$558.75
45331Facility Fee/Flexible Sigmoidoscopy w/Bx$599.75
45333Facility Fee/Flex Sig w/Polyp Removal$624.35
45335Facility Fee/Flex Sig w/Submucosal Injection$300.00
45338Facility Fee/Flex Sig w/Polyp Removal, Snare$624.35
45378Facility Fee/Colonoscopy$910.25
45379Facility Fee/Colon w/Removal Foreign Body$945.63
45380Facility Fee/Colon w/Bx$925.63
45381Facility Fee/Colon w/Submucosal Injection$300.00
45382Facility Fee/Colon w/Control of Bleeding$930.75
45384Facility Fee/Colon w/Polyp Removal, Hot Bx$951.25
45385Facility Fee/Colon w/Polyp Removal, Snare$943.56
45386Colsc flexible w/transendoscopic balloon dilat$1,530.50
45388Facility Fee/Colon w/Ablation$942.03
45390Facility Fee/Colon w/EMR$943.56
49082Facility Fee/Paracentesis w/o Imaging Guidance$250.00
G0104Facility Fee/Flex Sigmoidoscopy Screening$0.00
G0105Facility Fee/Colon Screening, High Risk$910.25
G0121Facility Fee/Colon Screening, Not High Risk$910.25
G8907No Burn/Fall/Site/Transfer$0.00
G8908Pt Burn Documented$0.00
G8909No Pt Burn$0.00
G8910Pt Fall$0.00
G8911No Pt Fall$0.00
G8912Wrong Site/Side/Patient/Procedure$0.00
G8913Not Wrong Site/Side/Patient/Procedure$0.00
G8914Pt Hospital Transfer /Admission$0.00
G8915No Pt Hospital Transfer/Admission$0.00
G8916Antibiotic Prophalaxis Started-on time$0.00
G8917Antibiotic Prophalaxis Started-not on time$0.00
G8918No Order for Antibiotic Prophylaxis$0.00


*The prices listed are the facility charges that are billed to the insurance. Every insurance company we participate with, we have a contracted allowed amount. To find out what you may be responsible for please contact your insurance company.