|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM
|
Professional
|
Both
|
$542.00
|
|
|
Service Code
|
HCPCS 21011
|
| Hospital Charge Code |
21011
|
| Min. Negotiated Rate |
$99.81 |
| Max. Negotiated Rate |
$398.82 |
| Rate for Payer: Aetna Commercial |
$338.16
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Mclaren Medicaid |
$168.48
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$398.82
|
| Rate for Payer: Priority Health Narrow Network |
$398.82
|
| Rate for Payer: Priority Health SBD |
$398.82
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM
|
Professional
|
Both
|
$542.00
|
|
|
Service Code
|
HCPCS 21011
|
| Min. Negotiated Rate |
$99.81 |
| Max. Negotiated Rate |
$398.82 |
| Rate for Payer: Aetna Commercial |
$338.16
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Mclaren Medicaid |
$168.48
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$398.82
|
| Rate for Payer: Priority Health Narrow Network |
$398.82
|
| Rate for Payer: Priority Health SBD |
$398.82
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM
|
Facility
|
OP
|
$542.00
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
21011
|
| Min. Negotiated Rate |
$259.01 |
| Max. Negotiated Rate |
$4,496.47 |
| Rate for Payer: Aetna Commercial |
$460.70
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$937.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cash Price |
$433.60
|
| Rate for Payer: Cofinity Commercial |
$466.12
|
| Rate for Payer: Cofinity Commercial |
$379.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$487.80
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.70
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$460.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,496.47
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.18
|
| Rate for Payer: Priority Health SBD |
$341.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$259.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 21930
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$9,087.30 |
| Rate for Payer: Aetna Commercial |
$484.47
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS Trust/PPO |
$9,087.30
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Mclaren Medicaid |
$236.43
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.67
|
| Rate for Payer: Priority Health Narrow Network |
$559.67
|
| Rate for Payer: Priority Health SBD |
$559.67
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Professional
|
Both
|
$1,234.00
|
|
|
Service Code
|
HCPCS 21930
|
| Hospital Charge Code |
21930
|
| Min. Negotiated Rate |
$236.43 |
| Max. Negotiated Rate |
$9,087.30 |
| Rate for Payer: Aetna Commercial |
$484.47
|
| Rate for Payer: BCBS Complete |
$248.25
|
| Rate for Payer: BCBS Trust/PPO |
$9,087.30
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Mclaren Medicaid |
$236.43
|
| Rate for Payer: Meridian Medicaid |
$248.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.67
|
| Rate for Payer: Priority Health Narrow Network |
$559.67
|
| Rate for Payer: Priority Health SBD |
$559.67
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Facility
|
OP
|
$1,234.00
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
21930
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$363.46 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$1,048.90
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$863.80
|
| Rate for Payer: Cofinity Commercial |
$1,061.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,110.60
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,048.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$777.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$363.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Facility
|
IP
|
$1,234.00
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
21930
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$777.42 |
| Max. Negotiated Rate |
$1,110.60 |
| Rate for Payer: Aetna Commercial |
$1,048.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.10
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$1,061.24
|
| Rate for Payer: Cofinity Commercial |
$863.80
|
| Rate for Payer: Healthscope Commercial |
$1,110.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: PHP Commercial |
$1,048.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health SBD |
$777.42
|
|
|
PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 28043
|
| Min. Negotiated Rate |
$168.48 |
| Max. Negotiated Rate |
$529.88 |
| Rate for Payer: Aetna Commercial |
$343.53
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCBS Trust/PPO |
$529.88
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Mclaren Medicaid |
$168.48
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.77
|
| Rate for Payer: Priority Health Narrow Network |
$396.77
|
| Rate for Payer: Priority Health SBD |
$396.77
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Facility
|
IP
|
$1,023.00
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
27632
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$644.49 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna Commercial |
$869.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.95
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$716.10
|
| Rate for Payer: Cofinity Commercial |
$879.78
|
| Rate for Payer: Healthscope Commercial |
$920.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$869.55
|
| Rate for Payer: PHP Commercial |
$869.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health SBD |
$644.49
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,023.00
|
|
|
Service Code
|
HCPCS 27632
|
| Min. Negotiated Rate |
$263.91 |
| Max. Negotiated Rate |
$716.10 |
| Rate for Payer: Aetna Commercial |
$551.46
|
| Rate for Payer: BCBS Complete |
$277.11
|
| Rate for Payer: BCBS Trust/PPO |
$579.02
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Mclaren Medicaid |
$263.91
|
| Rate for Payer: Meridian Medicaid |
$277.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.63
|
| Rate for Payer: Priority Health Narrow Network |
$629.63
|
| Rate for Payer: Priority Health SBD |
$629.63
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,023.00
|
|
|
Service Code
|
HCPCS 27632
|
| Hospital Charge Code |
27632
|
| Min. Negotiated Rate |
$263.91 |
| Max. Negotiated Rate |
$716.10 |
| Rate for Payer: Aetna Commercial |
$551.46
|
| Rate for Payer: BCBS Complete |
$277.11
|
| Rate for Payer: BCBS Trust/PPO |
$579.02
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Mclaren Medicaid |
$263.91
|
| Rate for Payer: Meridian Medicaid |
$277.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.63
|
| Rate for Payer: Priority Health Narrow Network |
$629.63
|
| Rate for Payer: Priority Health SBD |
$629.63
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Facility
|
OP
|
$1,023.00
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
27632
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$405.70 |
| Max. Negotiated Rate |
$7,745.99 |
| Rate for Payer: Aetna Commercial |
$869.55
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,044.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$716.10
|
| Rate for Payer: Cofinity Commercial |
$879.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$920.70
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$869.55
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$869.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,745.99
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health Narrow Network |
$6,196.79
|
| Rate for Payer: Priority Health SBD |
$644.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$405.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
HCPCS 27043
|
| Hospital Charge Code |
27043
|
| Min. Negotiated Rate |
$110.41 |
| Max. Negotiated Rate |
$720.53 |
| Rate for Payer: Aetna Commercial |
$627.36
|
| Rate for Payer: BCBS Complete |
$318.26
|
| Rate for Payer: BCBS Trust/PPO |
$110.41
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Mclaren Medicaid |
$303.10
|
| Rate for Payer: Meridian Medicaid |
$318.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: Priority Health SBD |
$720.53
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>
|
Facility
|
OP
|
$967.00
|
|
|
Service Code
|
CPT 27043
|
| Hospital Charge Code |
27043
|
| Min. Negotiated Rate |
$465.95 |
| Max. Negotiated Rate |
$7,382.58 |
| Rate for Payer: Aetna Commercial |
$821.95
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,445.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$831.62
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$870.30
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$821.95
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$821.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,382.58
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health Narrow Network |
$5,906.06
|
| Rate for Payer: Priority Health SBD |
$609.21
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$465.95
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>
|
Professional
|
Both
|
$967.00
|
|
|
Service Code
|
HCPCS 27043
|
| Min. Negotiated Rate |
$110.41 |
| Max. Negotiated Rate |
$720.53 |
| Rate for Payer: Aetna Commercial |
$627.36
|
| Rate for Payer: BCBS Complete |
$318.26
|
| Rate for Payer: BCBS Trust/PPO |
$110.41
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Mclaren Medicaid |
$303.10
|
| Rate for Payer: Meridian Medicaid |
$318.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$720.53
|
| Rate for Payer: Priority Health Narrow Network |
$720.53
|
| Rate for Payer: Priority Health SBD |
$720.53
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>
|
Facility
|
IP
|
$967.00
|
|
|
Service Code
|
CPT 27043
|
| Hospital Charge Code |
27043
|
| Min. Negotiated Rate |
$609.21 |
| Max. Negotiated Rate |
$870.30 |
| Rate for Payer: Aetna Commercial |
$821.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.55
|
| Rate for Payer: Cash Price |
$773.60
|
| Rate for Payer: Cofinity Commercial |
$676.90
|
| Rate for Payer: Cofinity Commercial |
$831.62
|
| Rate for Payer: Healthscope Commercial |
$870.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$821.95
|
| Rate for Payer: PHP Commercial |
$821.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$676.90
|
| Rate for Payer: Priority Health SBD |
$609.21
|
|
|
PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 23071
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$644.96 |
| Rate for Payer: Aetna Commercial |
$562.05
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS Trust/PPO |
$434.79
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Mclaren Medicaid |
$271.79
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$644.96
|
| Rate for Payer: Priority Health Narrow Network |
$644.96
|
| Rate for Payer: Priority Health SBD |
$644.96
|
|
|
PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Professional
|
Both
|
$850.00
|
|
|
Service Code
|
HCPCS 23075
|
| Min. Negotiated Rate |
$213.85 |
| Max. Negotiated Rate |
$652.45 |
| Rate for Payer: Aetna Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$224.54
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Cash Price |
$680.00
|
| Rate for Payer: Mclaren Medicaid |
$213.85
|
| Rate for Payer: Meridian Medicaid |
$224.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.03
|
| Rate for Payer: Priority Health Narrow Network |
$505.03
|
| Rate for Payer: Priority Health SBD |
$505.03
|
|
|
PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Professional
|
Both
|
$1,279.00
|
|
|
Service Code
|
HCPCS 27327
|
| Hospital Charge Code |
27327
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$1,601.28 |
| Rate for Payer: Aetna Commercial |
$414.89
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,601.28
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.61
|
| Rate for Payer: Priority Health Narrow Network |
$484.61
|
| Rate for Payer: Priority Health SBD |
$484.61
|
|
|
PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Professional
|
Both
|
$1,279.00
|
|
|
Service Code
|
HCPCS 27327
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$1,601.28 |
| Rate for Payer: Aetna Commercial |
$414.89
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,601.28
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$484.61
|
| Rate for Payer: Priority Health Narrow Network |
$484.61
|
| Rate for Payer: Priority Health SBD |
$484.61
|
|
|
PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Facility
|
IP
|
$1,279.00
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
27327
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$805.77 |
| Max. Negotiated Rate |
$1,151.10 |
| Rate for Payer: Aetna Commercial |
$1,087.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.35
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cofinity Commercial |
$895.30
|
| Rate for Payer: Cofinity Commercial |
$1,099.94
|
| Rate for Payer: Healthscope Commercial |
$1,151.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,087.15
|
| Rate for Payer: PHP Commercial |
$1,087.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.30
|
| Rate for Payer: Priority Health SBD |
$805.77
|
|
|
PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Facility
|
OP
|
$1,279.00
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
27327
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$1,087.15
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$831.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$771.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cash Price |
$1,023.20
|
| Rate for Payer: Cofinity Commercial |
$1,099.94
|
| Rate for Payer: Cofinity Commercial |
$895.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,151.10
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,087.15
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,087.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$805.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$315.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
PR EXCISION/UNROOFING CYST KIDNEY
|
Professional
|
Both
|
$2,867.00
|
|
|
Service Code
|
HCPCS 50280
|
| Min. Negotiated Rate |
$600.45 |
| Max. Negotiated Rate |
$3,769.95 |
| Rate for Payer: Aetna Commercial |
$1,243.00
|
| Rate for Payer: BCBS Complete |
$630.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,769.95
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Cash Price |
$2,293.60
|
| Rate for Payer: Mclaren Medicaid |
$600.45
|
| Rate for Payer: Meridian Medicaid |
$630.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$600.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,006.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,533.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,533.54
|
| Rate for Payer: Priority Health SBD |
$1,533.54
|
|
|
PR EXCISION VAGINAL CYST/TUMOR
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 57135
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$2,039.77 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: BCBS Complete |
$127.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.77
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Mclaren Medicaid |
$121.20
|
| Rate for Payer: Meridian Medicaid |
$127.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.96
|
| Rate for Payer: Priority Health Narrow Network |
$267.96
|
| Rate for Payer: Priority Health SBD |
$267.96
|
|
|
PR EXCISION VAGINAL SEPTUM
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 57130
|
| Min. Negotiated Rate |
$111.61 |
| Max. Negotiated Rate |
$2,624.59 |
| Rate for Payer: Aetna Commercial |
$202.91
|
| Rate for Payer: BCBS Complete |
$117.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,624.59
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Mclaren Medicaid |
$111.61
|
| Rate for Payer: Meridian Medicaid |
$117.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.13
|
| Rate for Payer: Priority Health Narrow Network |
$247.13
|
| Rate for Payer: Priority Health SBD |
$247.13
|
|
