Here is a summary of R-CPD fees and charges for evaluation and treatment.
Note: All BVI charges are billed to insurance companies through our National Provider Identifier (NPI) 1588449458
DISCLAIMER: The charges provided are an “accurate estimate” and are subject to change. Charges billed by MCDS are based on information provided to Bastian Voice Institute by MCDS; these charges should be verified with MCDS 630.796.4998.
BVI Fees
(eligible for BVI 15% discount if paid in full by patient)
DAY ONE — Initial Evaluation at Bastian Voice Institute (BVI) |
||
|---|---|---|
| Charge Fee | Description | Insurance Billing Code |
| $395.00 | Office Visit (BVI) | CPT 99204 |
| $567.00 | Videoendoscopic Swallow Study (BVI) | CPT 92612-GN |
| $100.00 | Review of Videoendoscopy | CPT 92613 |
| $1,062.00 | Total Day One Charges | (BVI offers a 15% discount if paid in full by patient) |
DAY TWO[1] — Esophagoscopy (surgeon fee to perform procedure) | ||
|---|---|---|
| A short outpatient procedure under general anesthesia at Midwest Center for Day Surgery (MCDS) | ||
| $600.00 | Esophagoscopy[2] | CPT 43192 |
ONE WEEK LATER — (in-person or via telemedicine) |
||
|---|---|---|
| Follow-up appointment with Physician Assistant or Nurse Practitioner | ||
| $220.00 | Post-op visit | CPT 99213 (99213-GT if telemedicine) |
TOTAL BVI Fees
Total charges before insurance processes the claim — $1,882.00
Total charges with 15% discount if paid in full on the date of service — $1,600.00
Surgery Center Fees
(You will be asked to pay for the Use of Facility & Botox the day of your procedure)
DAY TWO[1] — Facility Fee + Botox + Anesthesia at MCDS |
||
|---|---|---|
| $900.00 | Use of facility | Billed by MCDS[3] |
| $675.00 | Botox | Cost of Botox with no markup |
| $724.00 | Anesthesiologist | Billed by Anesthesia Associates[3] |
TOTAL Surgery Center Fees
Total charges before insurance processes the claim — $2,299.00
Disclaimers
BVI will submit a claim to your in-network insurance for Day 1 charges, Day 2 Esophagoscopy charges, and One-Week Later post-op charge. The surgery center (MCDS) and Anesthesia Associates will submit their charges.
BVI offers a 15% discount on our charges to those who pay in full at the time of service and who do not submit to insurance. MCDS offers its own payment options for those without insurance coverage or who are out of network.
Questions you may have about your MCDS bill can be discussed with the MCDS billing manager at (630) 852-9300. For questions about your bill to Anesthesia Associates, call (800) 242-1131 ext 5173.
Please note, we will not bill to insurance for patients who live outside the United States. These individuals can submit a claim to their insurance company to be reimbursed for their services with us but will be required to pay out-of-pocket on the date of service, as well as leave a bank card on file for future scheduled services.
- Anthem BCBS disclaimer: Day 2 charges are not covered by Anthem BCBS policies since the procedures is considered not medically necessary. The charges for Day 2 will be considered self-pay for both for the surgeon fee and the facility/anesthesia fee.
-
If your insurance company requires pre-authorization for this procedure we are NOT able to help you obtain that until you have officially become a patient and have been seen by us in our office.
Since each insurance company differs in coverage, this procedure has occasionally been denied as experimental and/or investigational. In the event this happens to you, we will help you appeal the denial. - These are self-pay costs. MCDS and Anesthesia Associates will charge a different, higher amount if you are using insurance. Please contact MCDS and your insurance company to determine your financial responsibility for these charges if you are using insurance.
The diagnosis codes used for billing are:
• R14.2 Eructation
• R14.0 Abdominal distension (gaseous)
• K22.4 Dyskinesia of esophagus
At your discretion, you may wish to contact your insurance company to verify coverage.