|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,450.66 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,946.86
|
| Rate for Payer: BCN Commercial |
$1,946.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.31
|
| Rate for Payer: UHC Core |
$1,923.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,450.66
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.72
|
| Rate for Payer: BCN Commercial |
$1,548.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
OP
|
$3,641.40
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,095.19
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Advantage |
$2,548.98
|
| Rate for Payer: Cofinity Commercial |
$3,131.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,277.26
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.05
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,095.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,294.08
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,366.91
|
| Rate for Payer: UHC Core |
$1,897.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,431.07
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
IP
|
$3,641.40
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,294.08 |
| Max. Negotiated Rate |
$3,277.26 |
| Rate for Payer: Aetna Commercial |
$3,095.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.91
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Advantage |
$2,548.98
|
| Rate for Payer: Cofinity Commercial |
$3,131.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.05
|
| Rate for Payer: PHP Commercial |
$3,095.19
|
| Rate for Payer: Priority Health SBD |
$2,294.08
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,883.92
|
| Rate for Payer: BCN Commercial |
$1,883.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBFASCIAL >5CM
|
Facility
|
OP
|
$6,297.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
76100536
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$5,352.45
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,093.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,977.11
|
| Rate for Payer: BCN Commercial |
$1,977.11
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,037.60
|
| Rate for Payer: Cash Price |
$5,037.60
|
| Rate for Payer: Cash Price |
$5,037.60
|
| Rate for Payer: Cofinity Advantage |
$4,407.90
|
| Rate for Payer: Cofinity Commercial |
$5,415.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,037.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$5,667.30
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,352.45
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,722.75
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$5,352.45
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$3,967.11
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,093.05
|
| Rate for Payer: UHC Core |
$3,280.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$2,474.72
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBFASCIAL >5CM
|
Facility
|
IP
|
$6,297.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
76100536
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,967.11 |
| Max. Negotiated Rate |
$5,667.30 |
| Rate for Payer: Aetna Commercial |
$5,352.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,093.05
|
| Rate for Payer: Cash Price |
$5,037.60
|
| Rate for Payer: Cofinity Advantage |
$4,407.90
|
| Rate for Payer: Cofinity Commercial |
$5,415.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,037.60
|
| Rate for Payer: Healthscope Commercial |
$5,667.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,352.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,722.75
|
| Rate for Payer: PHP Commercial |
$5,352.45
|
| Rate for Payer: Priority Health SBD |
$3,967.11
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,325.49 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.31
|
| Rate for Payer: UHC Core |
$1,923.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,450.66
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
OP
|
$2,476.24
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$2,104.80
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,609.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.58
|
| Rate for Payer: BCN Commercial |
$1,810.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,980.99
|
| Rate for Payer: Cash Price |
$1,980.99
|
| Rate for Payer: Cash Price |
$1,980.99
|
| Rate for Payer: Cofinity Advantage |
$1,733.37
|
| Rate for Payer: Cofinity Commercial |
$2,129.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,980.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$2,228.62
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,104.80
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,857.18
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$2,104.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,560.03
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.56
|
| Rate for Payer: UHC Core |
$1,290.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$973.16
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
IP
|
$2,476.24
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,560.03 |
| Max. Negotiated Rate |
$2,228.62 |
| Rate for Payer: Aetna Commercial |
$2,104.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,609.56
|
| Rate for Payer: Cash Price |
$1,980.99
|
| Rate for Payer: Cofinity Advantage |
$1,733.37
|
| Rate for Payer: Cofinity Commercial |
$2,129.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,980.99
|
| Rate for Payer: Healthscope Commercial |
$2,228.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,104.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,857.18
|
| Rate for Payer: PHP Commercial |
$2,104.80
|
| Rate for Payer: Priority Health SBD |
$1,560.03
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
IP
|
$4,527.12
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,852.09 |
| Max. Negotiated Rate |
$4,074.41 |
| Rate for Payer: Aetna Commercial |
$3,848.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,942.63
|
| Rate for Payer: Cash Price |
$3,621.70
|
| Rate for Payer: Cofinity Advantage |
$3,168.98
|
| Rate for Payer: Cofinity Commercial |
$3,893.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,621.70
|
| Rate for Payer: Healthscope Commercial |
$4,074.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,848.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,395.34
|
| Rate for Payer: PHP Commercial |
$3,848.05
|
| Rate for Payer: Priority Health SBD |
$2,852.09
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
OP
|
$4,527.12
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,848.05
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,942.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,621.70
|
| Rate for Payer: Cash Price |
$3,621.70
|
| Rate for Payer: Cash Price |
$3,621.70
|
| Rate for Payer: Cofinity Advantage |
$3,168.98
|
| Rate for Payer: Cofinity Commercial |
$3,893.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,621.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,074.41
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,848.05
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,395.34
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,848.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,852.09
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,942.63
|
| Rate for Payer: UHC Core |
$2,358.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,779.16
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM DEEP<3CM
|
Facility
|
IP
|
$4,367.60
|
|
|
Service Code
|
CPT 25076
|
| Hospital Charge Code |
76100515
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,751.59 |
| Max. Negotiated Rate |
$3,930.84 |
| Rate for Payer: Aetna Commercial |
$3,712.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,838.94
|
| Rate for Payer: Cash Price |
$3,494.08
|
| Rate for Payer: Cofinity Advantage |
$3,057.32
|
| Rate for Payer: Cofinity Commercial |
$3,756.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.08
|
| Rate for Payer: Healthscope Commercial |
$3,930.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,712.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,275.70
|
| Rate for Payer: PHP Commercial |
$3,712.46
|
| Rate for Payer: Priority Health SBD |
$2,751.59
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM DEEP<3CM
|
Facility
|
OP
|
$4,367.60
|
|
|
Service Code
|
CPT 25076
|
| Hospital Charge Code |
76100515
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,712.46
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,838.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$950.23
|
| Rate for Payer: BCN Commercial |
$950.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,494.08
|
| Rate for Payer: Cash Price |
$3,494.08
|
| Rate for Payer: Cash Price |
$3,494.08
|
| Rate for Payer: Cofinity Advantage |
$3,057.32
|
| Rate for Payer: Cofinity Commercial |
$3,756.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,930.84
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,712.46
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,275.70
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,712.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,751.59
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,838.94
|
| Rate for Payer: UHC Core |
$2,275.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,716.47
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM/WRIST, SQ <3CM
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
76100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.67
|
| Rate for Payer: BCN Commercial |
$1,479.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM/WRIST, SQ <3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
76100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE LEG/ANKLE SQ 3 CM/>
|
Facility
|
IP
|
$4,024.10
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
76100312
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,535.18 |
| Max. Negotiated Rate |
$3,621.69 |
| Rate for Payer: Aetna Commercial |
$3,420.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,615.66
|
| Rate for Payer: Cash Price |
$3,219.28
|
| Rate for Payer: Cofinity Advantage |
$2,816.87
|
| Rate for Payer: Cofinity Commercial |
$3,460.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,219.28
|
| Rate for Payer: Healthscope Commercial |
$3,621.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,018.07
|
| Rate for Payer: PHP Commercial |
$3,420.49
|
| Rate for Payer: Priority Health SBD |
$2,535.18
|
|
|
HC EXC TUMOR SOFT TISSUE LEG/ANKLE SQ 3 CM/>
|
Facility
|
OP
|
$4,024.10
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
76100312
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,377.78 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,420.49
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,615.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,377.78
|
| Rate for Payer: BCN Commercial |
$1,377.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$3,219.28
|
| Rate for Payer: Cash Price |
$3,219.28
|
| Rate for Payer: Cash Price |
$3,219.28
|
| Rate for Payer: Cofinity Advantage |
$2,816.87
|
| Rate for Payer: Cofinity Commercial |
$3,460.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,219.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,621.69
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.49
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,018.07
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,420.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,535.18
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,615.66
|
| Rate for Payer: UHC Core |
$2,096.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,581.47
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXC TUMOR SOFT TISSUE,NECK/ANT THORAX, SQ <3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
76100264
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,376.50 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
|
|
HC EXC TUMOR SOFT TISSUE,NECK/ANT THORAX, SQ <3CM
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
76100264
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$858.67 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,860.37
|
| Rate for Payer: BCN Commercial |
$1,860.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Advantage |
$1,529.44
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,376.50
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.20
|
| Rate for Payer: UHC Core |
$1,138.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$858.67
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
