|
PR EXCISION SYNOVIAL CYST POPLITEAL SPACE
|
Professional
|
Both
|
$1,689.00
|
|
|
Service Code
|
HCPCS 27345
|
| Min. Negotiated Rate |
$298.63 |
| Max. Negotiated Rate |
$1,266.75 |
| Rate for Payer: Aetna Commercial |
$608.21
|
| Rate for Payer: Aetna Medicare |
$472.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$653.60
|
| Rate for Payer: BCBS Complete |
$313.56
|
| Rate for Payer: BCBS MAPPO |
$453.89
|
| Rate for Payer: BCN Commercial |
$751.96
|
| Rate for Payer: BCN Medicare Advantage |
$453.89
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cash Price |
$1,351.20
|
| Rate for Payer: Cofinity Commercial |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$608.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.89
|
| Rate for Payer: Healthscope Commercial |
$839.70
|
| Rate for Payer: Healthscope Commercial |
$726.22
|
| Rate for Payer: Mclaren Medicaid |
$298.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.58
|
| Rate for Payer: Meridian Medicaid |
$313.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$499.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$863.10
|
| Rate for Payer: Nomi Health Commercial |
$544.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,266.75
|
| Rate for Payer: PACE SWMI |
$453.89
|
| Rate for Payer: PHP Medicare Advantage |
$453.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$803.81
|
| Rate for Payer: Priority Health Medicare |
$453.89
|
| Rate for Payer: Priority Health SBD |
$803.81
|
| Rate for Payer: Priority Health Tiered Network |
$803.81
|
| Rate for Payer: Railroad Medicare Medicare |
$453.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$839.76
|
| Rate for Payer: UHC Core |
$839.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$453.89
|
| Rate for Payer: UHC Exchange |
$839.76
|
| Rate for Payer: UHC Medicaid |
$298.63
|
| Rate for Payer: UHCCP Medicaid |
$298.63
|
|
|
PR EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH
|
Professional
|
Both
|
$1,310.00
|
|
|
Service Code
|
HCPCS 26180
|
| Min. Negotiated Rate |
$274.98 |
| Max. Negotiated Rate |
$982.50 |
| Rate for Payer: Aetna Commercial |
$557.53
|
| Rate for Payer: Aetna Medicare |
$432.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.14
|
| Rate for Payer: BCBS Complete |
$288.73
|
| Rate for Payer: BCBS MAPPO |
$416.07
|
| Rate for Payer: BCN Commercial |
$697.67
|
| Rate for Payer: BCN Medicare Advantage |
$416.07
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cash Price |
$1,048.00
|
| Rate for Payer: Cofinity Commercial |
$599.14
|
| Rate for Payer: Cofinity Commercial |
$557.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.07
|
| Rate for Payer: Healthscope Commercial |
$769.73
|
| Rate for Payer: Healthscope Commercial |
$665.71
|
| Rate for Payer: Mclaren Medicaid |
$274.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.87
|
| Rate for Payer: Meridian Medicaid |
$288.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.43
|
| Rate for Payer: Nomi Health Commercial |
$499.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$982.50
|
| Rate for Payer: PACE SWMI |
$416.07
|
| Rate for Payer: PHP Medicare Advantage |
$416.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$745.78
|
| Rate for Payer: Priority Health Medicare |
$416.07
|
| Rate for Payer: Priority Health SBD |
$745.78
|
| Rate for Payer: Priority Health Tiered Network |
$745.78
|
| Rate for Payer: Railroad Medicare Medicare |
$416.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.74
|
| Rate for Payer: UHC Core |
$771.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.07
|
| Rate for Payer: UHC Exchange |
$771.74
|
| Rate for Payer: UHC Medicaid |
$274.98
|
| Rate for Payer: UHCCP Medicaid |
$274.98
|
|
|
PR EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 26170
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$860.25 |
| Rate for Payer: Aetna Commercial |
$506.87
|
| Rate for Payer: Aetna Medicare |
$393.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$506.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$544.69
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$630.44
|
| Rate for Payer: BCN Medicare Advantage |
$378.26
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$544.69
|
| Rate for Payer: Cofinity Commercial |
$506.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.26
|
| Rate for Payer: Healthscope Commercial |
$699.78
|
| Rate for Payer: Healthscope Commercial |
$605.22
|
| Rate for Payer: Mclaren Medicaid |
$249.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.17
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$416.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.87
|
| Rate for Payer: Nomi Health Commercial |
$453.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.25
|
| Rate for Payer: PACE SWMI |
$378.26
|
| Rate for Payer: PHP Medicare Advantage |
$378.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$673.93
|
| Rate for Payer: Priority Health Medicare |
$378.26
|
| Rate for Payer: Priority Health SBD |
$673.93
|
| Rate for Payer: Priority Health Tiered Network |
$673.93
|
| Rate for Payer: Railroad Medicare Medicare |
$378.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.59
|
| Rate for Payer: UHC Core |
$703.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$378.26
|
| Rate for Payer: UHC Exchange |
$703.59
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS
|
Professional
|
Both
|
$2,136.00
|
|
|
Service Code
|
HCPCS 60280
|
| Min. Negotiated Rate |
$261.35 |
| Max. Negotiated Rate |
$1,602.00 |
| Rate for Payer: PHP Medicare Advantage |
$398.35
|
| Rate for Payer: Aetna Commercial |
$533.79
|
| Rate for Payer: Aetna Medicare |
$414.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.62
|
| Rate for Payer: BCBS Complete |
$274.42
|
| Rate for Payer: BCBS MAPPO |
$398.35
|
| Rate for Payer: BCN Commercial |
$688.21
|
| Rate for Payer: BCN Medicare Advantage |
$398.35
|
| Rate for Payer: Cash Price |
$1,708.80
|
| Rate for Payer: Cash Price |
$1,708.80
|
| Rate for Payer: Cofinity Commercial |
$573.62
|
| Rate for Payer: Cofinity Commercial |
$533.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.35
|
| Rate for Payer: Healthscope Commercial |
$736.95
|
| Rate for Payer: Healthscope Commercial |
$637.36
|
| Rate for Payer: Mclaren Medicaid |
$261.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.27
|
| Rate for Payer: Meridian Medicaid |
$274.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.31
|
| Rate for Payer: Nomi Health Commercial |
$478.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.00
|
| Rate for Payer: PACE SWMI |
$398.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$746.26
|
| Rate for Payer: Priority Health Medicare |
$398.35
|
| Rate for Payer: Priority Health SBD |
$746.26
|
| Rate for Payer: Priority Health Tiered Network |
$746.26
|
| Rate for Payer: Railroad Medicare Medicare |
$398.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.23
|
| Rate for Payer: UHC Core |
$770.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.35
|
| Rate for Payer: UHC Exchange |
$770.23
|
| Rate for Payer: UHC Medicaid |
$261.35
|
| Rate for Payer: UHCCP Medicaid |
$261.35
|
|
|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT
|
Professional
|
Both
|
$2,263.00
|
|
|
Service Code
|
HCPCS 60281
|
| Min. Negotiated Rate |
$335.05 |
| Max. Negotiated Rate |
$1,697.25 |
| Rate for Payer: Aetna Commercial |
$688.45
|
| Rate for Payer: Aetna Medicare |
$534.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$688.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$739.83
|
| Rate for Payer: BCBS Complete |
$351.80
|
| Rate for Payer: BCBS MAPPO |
$513.77
|
| Rate for Payer: BCN Commercial |
$900.35
|
| Rate for Payer: BCN Medicare Advantage |
$513.77
|
| Rate for Payer: Cash Price |
$1,810.40
|
| Rate for Payer: Cash Price |
$1,810.40
|
| Rate for Payer: Cofinity Commercial |
$739.83
|
| Rate for Payer: Cofinity Commercial |
$688.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.77
|
| Rate for Payer: Healthscope Commercial |
$950.47
|
| Rate for Payer: Healthscope Commercial |
$822.03
|
| Rate for Payer: Mclaren Medicaid |
$335.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.46
|
| Rate for Payer: Meridian Medicaid |
$351.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$565.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,057.46
|
| Rate for Payer: Nomi Health Commercial |
$616.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.25
|
| Rate for Payer: PACE SWMI |
$513.77
|
| Rate for Payer: PHP Medicare Advantage |
$513.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$976.28
|
| Rate for Payer: Priority Health Medicare |
$513.77
|
| Rate for Payer: Priority Health SBD |
$976.28
|
| Rate for Payer: Priority Health Tiered Network |
$976.28
|
| Rate for Payer: Railroad Medicare Medicare |
$513.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.22
|
| Rate for Payer: UHC Core |
$1,022.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$513.77
|
| Rate for Payer: UHC Exchange |
$1,022.22
|
| Rate for Payer: UHC Medicaid |
$335.05
|
| Rate for Payer: UHCCP Medicaid |
$335.05
|
|
|
PR EXCISION TONSIL TAGS
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS 42860
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$361.64 |
| Rate for Payer: Aetna Commercial |
$231.86
|
| Rate for Payer: Aetna Medicare |
$179.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.16
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$173.03
|
| Rate for Payer: BCN Commercial |
$296.80
|
| Rate for Payer: BCN Medicare Advantage |
$173.03
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cofinity Commercial |
$249.16
|
| Rate for Payer: Cofinity Commercial |
$231.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.03
|
| Rate for Payer: Healthscope Commercial |
$320.11
|
| Rate for Payer: Healthscope Commercial |
$276.85
|
| Rate for Payer: Mclaren Medicaid |
$114.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.68
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$190.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.53
|
| Rate for Payer: Nomi Health Commercial |
$207.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$293.25
|
| Rate for Payer: PACE SWMI |
$173.03
|
| Rate for Payer: PHP Medicare Advantage |
$173.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$361.64
|
| Rate for Payer: Priority Health Medicare |
$173.03
|
| Rate for Payer: Priority Health SBD |
$361.64
|
| Rate for Payer: Priority Health Tiered Network |
$361.64
|
| Rate for Payer: Railroad Medicare Medicare |
$173.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.23
|
| Rate for Payer: UHC Core |
$324.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$173.03
|
| Rate for Payer: UHC Exchange |
$324.23
|
| Rate for Payer: UHC Medicaid |
$114.59
|
| Rate for Payer: UHCCP Medicaid |
$114.59
|
|
|
PR EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL
|
Professional
|
Both
|
$4,066.00
|
|
|
Service Code
|
HCPCS 31785
|
| Min. Negotiated Rate |
$585.96 |
| Max. Negotiated Rate |
$3,049.50 |
| Rate for Payer: Aetna Commercial |
$1,219.04
|
| Rate for Payer: Aetna Medicare |
$946.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,219.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,310.01
|
| Rate for Payer: BCBS Complete |
$615.26
|
| Rate for Payer: BCBS MAPPO |
$909.73
|
| Rate for Payer: BCN Commercial |
$1,608.48
|
| Rate for Payer: BCN Medicare Advantage |
$909.73
|
| Rate for Payer: Cash Price |
$3,252.80
|
| Rate for Payer: Cash Price |
$3,252.80
|
| Rate for Payer: Cofinity Commercial |
$1,310.01
|
| Rate for Payer: Cofinity Commercial |
$1,219.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.73
|
| Rate for Payer: Healthscope Commercial |
$1,683.00
|
| Rate for Payer: Healthscope Commercial |
$1,455.57
|
| Rate for Payer: Mclaren Medicaid |
$585.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.22
|
| Rate for Payer: Meridian Medicaid |
$615.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,000.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.40
|
| Rate for Payer: Nomi Health Commercial |
$1,091.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,049.50
|
| Rate for Payer: PACE SWMI |
$909.73
|
| Rate for Payer: PHP Medicare Advantage |
$909.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$585.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,514.71
|
| Rate for Payer: Priority Health Medicare |
$909.73
|
| Rate for Payer: Priority Health SBD |
$1,514.71
|
| Rate for Payer: Priority Health Tiered Network |
$1,514.71
|
| Rate for Payer: Railroad Medicare Medicare |
$909.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,882.68
|
| Rate for Payer: UHC Core |
$1,882.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$909.73
|
| Rate for Payer: UHC Exchange |
$1,882.68
|
| Rate for Payer: UHC Medicaid |
$585.96
|
| Rate for Payer: UHCCP Medicaid |
$585.96
|
|
|
PR EXCISION TROCHANTERIC BURSA/CALCIFICATION
|
Professional
|
Both
|
$1,728.00
|
|
|
Service Code
|
HCPCS 27062
|
| Min. Negotiated Rate |
$276.05 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Aetna Commercial |
$562.26
|
| Rate for Payer: Aetna Medicare |
$436.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.22
|
| Rate for Payer: BCBS Complete |
$289.85
|
| Rate for Payer: BCBS MAPPO |
$419.60
|
| Rate for Payer: BCN Commercial |
$696.17
|
| Rate for Payer: BCN Medicare Advantage |
$419.60
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cash Price |
$1,382.40
|
| Rate for Payer: Cofinity Commercial |
$604.22
|
| Rate for Payer: Cofinity Commercial |
$562.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.60
|
| Rate for Payer: Healthscope Commercial |
$776.26
|
| Rate for Payer: Healthscope Commercial |
$671.36
|
| Rate for Payer: Mclaren Medicaid |
$276.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.58
|
| Rate for Payer: Meridian Medicaid |
$289.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$461.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.77
|
| Rate for Payer: Nomi Health Commercial |
$503.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,296.00
|
| Rate for Payer: PACE SWMI |
$419.60
|
| Rate for Payer: PHP Medicare Advantage |
$419.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$744.19
|
| Rate for Payer: Priority Health Medicare |
$419.60
|
| Rate for Payer: Priority Health SBD |
$744.19
|
| Rate for Payer: Priority Health Tiered Network |
$744.19
|
| Rate for Payer: Railroad Medicare Medicare |
$419.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$788.72
|
| Rate for Payer: UHC Core |
$788.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$419.60
|
| Rate for Payer: UHC Exchange |
$788.72
|
| Rate for Payer: UHC Medicaid |
$276.05
|
| Rate for Payer: UHCCP Medicaid |
$276.05
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 21931
|
| Hospital Charge Code |
21931
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$837.52 |
| Rate for Payer: Aetna Commercial |
$597.10
|
| Rate for Payer: Aetna Medicare |
$463.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.66
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$445.60
|
| Rate for Payer: BCN Commercial |
$715.60
|
| Rate for Payer: BCN Medicare Advantage |
$445.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$641.66
|
| Rate for Payer: Cofinity Commercial |
$597.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.60
|
| Rate for Payer: Healthscope Commercial |
$824.36
|
| Rate for Payer: Healthscope Commercial |
$712.96
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.88
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$490.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$837.52
|
| Rate for Payer: Nomi Health Commercial |
$534.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$445.60
|
| Rate for Payer: PHP Medicare Advantage |
$445.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$764.96
|
| Rate for Payer: Priority Health Medicare |
$445.60
|
| Rate for Payer: Priority Health SBD |
$764.96
|
| Rate for Payer: Priority Health Tiered Network |
$764.96
|
| Rate for Payer: Railroad Medicare Medicare |
$445.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.58
|
| Rate for Payer: UHC Core |
$827.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.60
|
| Rate for Payer: UHC Exchange |
$827.58
|
| Rate for Payer: UHC Medicaid |
$289.25
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Facility
|
OP
|
$767.00
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
21931
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$483.21 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$651.95
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.55
|
| 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 |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Advantage |
$536.90
|
| Rate for Payer: Cofinity Commercial |
$659.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$613.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$690.30
|
| 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 |
$651.95
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$651.95
|
| 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 |
$483.21
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Facility
|
IP
|
$767.00
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
21931
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$483.21 |
| Max. Negotiated Rate |
$690.30 |
| Rate for Payer: Aetna Commercial |
$651.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.55
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Advantage |
$536.90
|
| Rate for Payer: Cofinity Commercial |
$659.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$613.60
|
| Rate for Payer: Healthscope Commercial |
$690.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$651.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PHP Commercial |
$651.95
|
| Rate for Payer: Priority Health SBD |
$483.21
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$767.00
|
|
|
Service Code
|
HCPCS 21931
|
| Min. Negotiated Rate |
$289.25 |
| Max. Negotiated Rate |
$837.52 |
| Rate for Payer: Aetna Commercial |
$597.10
|
| Rate for Payer: Aetna Medicare |
$463.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.66
|
| Rate for Payer: BCBS Complete |
$303.71
|
| Rate for Payer: BCBS MAPPO |
$445.60
|
| Rate for Payer: BCN Commercial |
$715.60
|
| Rate for Payer: BCN Medicare Advantage |
$445.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cash Price |
$613.60
|
| Rate for Payer: Cofinity Commercial |
$641.66
|
| Rate for Payer: Cofinity Commercial |
$597.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.60
|
| Rate for Payer: Healthscope Commercial |
$824.36
|
| Rate for Payer: Healthscope Commercial |
$712.96
|
| Rate for Payer: Mclaren Medicaid |
$289.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.88
|
| Rate for Payer: Meridian Medicaid |
$303.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$490.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$837.52
|
| Rate for Payer: Nomi Health Commercial |
$534.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$575.25
|
| Rate for Payer: PACE SWMI |
$445.60
|
| Rate for Payer: PHP Medicare Advantage |
$445.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$764.96
|
| Rate for Payer: Priority Health Medicare |
$445.60
|
| Rate for Payer: Priority Health SBD |
$764.96
|
| Rate for Payer: Priority Health Tiered Network |
$764.96
|
| Rate for Payer: Railroad Medicare Medicare |
$445.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.58
|
| Rate for Payer: UHC Core |
$827.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.60
|
| Rate for Payer: UHC Exchange |
$827.58
|
| Rate for Payer: UHC Medicaid |
$289.25
|
| Rate for Payer: UHCCP Medicaid |
$289.25
|
|
|
PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>
|
Professional
|
Both
|
$941.00
|
|
|
Service Code
|
HCPCS 28039
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$705.75 |
| Rate for Payer: Aetna Commercial |
$412.01
|
| Rate for Payer: Aetna Medicare |
$319.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.76
|
| Rate for Payer: BCBS Complete |
$211.12
|
| Rate for Payer: BCBS MAPPO |
$307.47
|
| Rate for Payer: BCN Commercial |
$509.43
|
| Rate for Payer: BCN Medicare Advantage |
$307.47
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cash Price |
$752.80
|
| Rate for Payer: Cofinity Commercial |
$442.76
|
| Rate for Payer: Cofinity Commercial |
$412.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.47
|
| Rate for Payer: Healthscope Commercial |
$568.82
|
| Rate for Payer: Healthscope Commercial |
$491.95
|
| Rate for Payer: Mclaren Medicaid |
$201.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.84
|
| Rate for Payer: Meridian Medicaid |
$211.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$602.21
|
| Rate for Payer: Nomi Health Commercial |
$368.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$705.75
|
| Rate for Payer: PACE SWMI |
$307.47
|
| Rate for Payer: PHP Medicare Advantage |
$307.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$544.56
|
| Rate for Payer: Priority Health Medicare |
$307.47
|
| Rate for Payer: Priority Health SBD |
$544.56
|
| Rate for Payer: Priority Health Tiered Network |
$544.56
|
| Rate for Payer: Railroad Medicare Medicare |
$307.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$603.45
|
| Rate for Payer: UHC Core |
$603.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$307.47
|
| Rate for Payer: UHC Exchange |
$603.45
|
| Rate for Payer: UHC Medicaid |
$201.07
|
| Rate for Payer: UHCCP Medicaid |
$201.07
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>
|
Professional
|
Both
|
$672.00
|
|
|
Service Code
|
HCPCS 21012
|
| Min. Negotiated Rate |
$206.61 |
| Max. Negotiated Rate |
$600.01 |
| Rate for Payer: PHP Medicare Advantage |
$314.98
|
| Rate for Payer: Aetna Commercial |
$422.07
|
| Rate for Payer: Aetna Medicare |
$327.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.57
|
| Rate for Payer: BCBS Complete |
$216.94
|
| Rate for Payer: BCBS MAPPO |
$314.98
|
| Rate for Payer: BCN Commercial |
$516.41
|
| Rate for Payer: BCN Medicare Advantage |
$314.98
|
| Rate for Payer: Cash Price |
$537.60
|
| Rate for Payer: Cash Price |
$537.60
|
| Rate for Payer: Cofinity Commercial |
$453.57
|
| Rate for Payer: Cofinity Commercial |
$422.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.98
|
| Rate for Payer: Healthscope Commercial |
$582.71
|
| Rate for Payer: Healthscope Commercial |
$503.97
|
| Rate for Payer: Mclaren Medicaid |
$206.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.73
|
| Rate for Payer: Meridian Medicaid |
$216.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.01
|
| Rate for Payer: Nomi Health Commercial |
$377.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$504.00
|
| Rate for Payer: PACE SWMI |
$314.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$552.02
|
| Rate for Payer: Priority Health Medicare |
$314.98
|
| Rate for Payer: Priority Health SBD |
$552.02
|
| Rate for Payer: Priority Health Tiered Network |
$552.02
|
| Rate for Payer: Railroad Medicare Medicare |
$314.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.83
|
| Rate for Payer: UHC Core |
$586.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$314.98
|
| Rate for Payer: UHC Exchange |
$586.83
|
| Rate for Payer: UHC Medicaid |
$206.61
|
| Rate for Payer: UHCCP Medicaid |
$206.61
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 21011
|
| Min. Negotiated Rate |
$159.54 |
| Max. Negotiated Rate |
$455.35 |
| Rate for Payer: Aetna Commercial |
$322.56
|
| Rate for Payer: Aetna Medicare |
$250.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.64
|
| Rate for Payer: BCBS Complete |
$167.52
|
| Rate for Payer: BCBS MAPPO |
$240.72
|
| Rate for Payer: BCN Commercial |
$399.39
|
| Rate for Payer: BCN Medicare Advantage |
$240.72
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$346.64
|
| Rate for Payer: Cofinity Commercial |
$322.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.72
|
| Rate for Payer: Healthscope Commercial |
$445.33
|
| Rate for Payer: Healthscope Commercial |
$385.15
|
| Rate for Payer: Mclaren Medicaid |
$159.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.76
|
| Rate for Payer: Meridian Medicaid |
$167.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$264.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.35
|
| Rate for Payer: Nomi Health Commercial |
$288.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$427.50
|
| Rate for Payer: PACE SWMI |
$240.72
|
| Rate for Payer: PHP Medicare Advantage |
$240.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$426.93
|
| Rate for Payer: Priority Health Medicare |
$240.72
|
| Rate for Payer: Priority Health SBD |
$426.93
|
| Rate for Payer: Priority Health Tiered Network |
$426.93
|
| Rate for Payer: Railroad Medicare Medicare |
$240.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.69
|
| Rate for Payer: UHC Core |
$442.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$240.72
|
| Rate for Payer: UHC Exchange |
$442.69
|
| Rate for Payer: UHC Medicaid |
$159.54
|
| Rate for Payer: UHCCP Medicaid |
$159.54
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
21930
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$817.11 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.05
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Advantage |
$907.90
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.75
|
| Rate for Payer: PHP Commercial |
$1,102.45
|
| Rate for Payer: Priority Health SBD |
$817.11
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 21930
|
| Hospital Charge Code |
21930
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Aetna Commercial |
$458.99
|
| Rate for Payer: Aetna Medicare |
$356.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.24
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$342.53
|
| Rate for Payer: BCN Commercial |
$555.75
|
| Rate for Payer: BCN Medicare Advantage |
$342.53
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$493.24
|
| Rate for Payer: Cofinity Commercial |
$458.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.53
|
| Rate for Payer: Healthscope Commercial |
$633.68
|
| Rate for Payer: Healthscope Commercial |
$548.05
|
| Rate for Payer: Mclaren Medicaid |
$224.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.66
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$376.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.51
|
| Rate for Payer: Nomi Health Commercial |
$411.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.75
|
| Rate for Payer: PACE SWMI |
$342.53
|
| Rate for Payer: PHP Medicare Advantage |
$342.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$594.08
|
| Rate for Payer: Priority Health Medicare |
$342.53
|
| Rate for Payer: Priority Health SBD |
$594.08
|
| Rate for Payer: Priority Health Tiered Network |
$594.08
|
| Rate for Payer: Railroad Medicare Medicare |
$342.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.86
|
| Rate for Payer: UHC Core |
$633.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$342.53
|
| Rate for Payer: UHC Exchange |
$633.86
|
| Rate for Payer: UHC Medicaid |
$224.08
|
| Rate for Payer: UHCCP Medicaid |
$224.08
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 21930
|
| Min. Negotiated Rate |
$224.08 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Aetna Commercial |
$458.99
|
| Rate for Payer: Aetna Medicare |
$356.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.24
|
| Rate for Payer: BCBS Complete |
$235.28
|
| Rate for Payer: BCBS MAPPO |
$342.53
|
| Rate for Payer: BCN Commercial |
$555.75
|
| Rate for Payer: BCN Medicare Advantage |
$342.53
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$493.24
|
| Rate for Payer: Cofinity Commercial |
$458.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.53
|
| Rate for Payer: Healthscope Commercial |
$633.68
|
| Rate for Payer: Healthscope Commercial |
$548.05
|
| Rate for Payer: Mclaren Medicaid |
$224.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.66
|
| Rate for Payer: Meridian Medicaid |
$235.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$376.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.51
|
| Rate for Payer: Nomi Health Commercial |
$411.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.75
|
| Rate for Payer: PACE SWMI |
$342.53
|
| Rate for Payer: PHP Medicare Advantage |
$342.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$594.08
|
| Rate for Payer: Priority Health Medicare |
$342.53
|
| Rate for Payer: Priority Health SBD |
$594.08
|
| Rate for Payer: Priority Health Tiered Network |
$594.08
|
| Rate for Payer: Railroad Medicare Medicare |
$342.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.86
|
| Rate for Payer: UHC Core |
$633.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$342.53
|
| Rate for Payer: UHC Exchange |
$633.86
|
| Rate for Payer: UHC Medicaid |
$224.08
|
| Rate for Payer: UHCCP Medicaid |
$224.08
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
21930
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$817.11 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.05
|
| 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 |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Advantage |
$907.90
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| 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 |
$1,102.45
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.75
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,102.45
|
| 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 |
$817.11
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM
|
Professional
|
Both
|
$691.00
|
|
|
Service Code
|
HCPCS 28043
|
| Min. Negotiated Rate |
$157.83 |
| Max. Negotiated Rate |
$518.25 |
| Rate for Payer: Aetna Commercial |
$321.69
|
| Rate for Payer: Aetna Medicare |
$249.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.70
|
| Rate for Payer: BCBS Complete |
$165.72
|
| Rate for Payer: BCBS MAPPO |
$240.07
|
| Rate for Payer: BCN Commercial |
$395.90
|
| Rate for Payer: BCN Medicare Advantage |
$240.07
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$345.70
|
| Rate for Payer: Cofinity Commercial |
$321.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.07
|
| Rate for Payer: Healthscope Commercial |
$444.13
|
| Rate for Payer: Healthscope Commercial |
$384.11
|
| Rate for Payer: Mclaren Medicaid |
$157.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.07
|
| Rate for Payer: Meridian Medicaid |
$165.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$264.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.98
|
| Rate for Payer: Nomi Health Commercial |
$288.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$518.25
|
| Rate for Payer: PACE SWMI |
$240.07
|
| Rate for Payer: PHP Medicare Advantage |
$240.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$423.19
|
| Rate for Payer: Priority Health Medicare |
$240.07
|
| Rate for Payer: Priority Health SBD |
$423.19
|
| Rate for Payer: Priority Health Tiered Network |
$423.19
|
| Rate for Payer: Railroad Medicare Medicare |
$240.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.24
|
| Rate for Payer: UHC Core |
$455.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$240.07
|
| Rate for Payer: UHC Exchange |
$455.24
|
| Rate for Payer: UHC Medicaid |
$157.83
|
| Rate for Payer: UHCCP Medicaid |
$157.83
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Facility
|
OP
|
$1,074.00
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
27632
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$676.62 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$912.90
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.10
|
| 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 |
$859.20
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cofinity Advantage |
$751.80
|
| Rate for Payer: Cofinity Commercial |
$923.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$966.60
|
| 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 |
$912.90
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$805.50
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$912.90
|
| 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 |
$676.62
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,074.00
|
|
|
Service Code
|
HCPCS 27632
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$805.50 |
| Rate for Payer: Aetna Commercial |
$515.19
|
| Rate for Payer: Aetna Medicare |
$399.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.64
|
| Rate for Payer: BCBS Complete |
$263.24
|
| Rate for Payer: BCBS MAPPO |
$384.47
|
| Rate for Payer: BCN Commercial |
$623.48
|
| Rate for Payer: BCN Medicare Advantage |
$384.47
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cofinity Commercial |
$553.64
|
| Rate for Payer: Cofinity Commercial |
$515.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.47
|
| Rate for Payer: Healthscope Commercial |
$711.27
|
| Rate for Payer: Healthscope Commercial |
$615.15
|
| Rate for Payer: Mclaren Medicaid |
$250.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.69
|
| Rate for Payer: Meridian Medicaid |
$263.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$422.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.72
|
| Rate for Payer: Nomi Health Commercial |
$461.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$805.50
|
| Rate for Payer: PACE SWMI |
$384.47
|
| Rate for Payer: PHP Medicare Advantage |
$384.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$666.48
|
| Rate for Payer: Priority Health Medicare |
$384.47
|
| Rate for Payer: Priority Health SBD |
$666.48
|
| Rate for Payer: Priority Health Tiered Network |
$666.48
|
| Rate for Payer: Railroad Medicare Medicare |
$384.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.03
|
| Rate for Payer: UHC Core |
$724.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$384.47
|
| Rate for Payer: UHC Exchange |
$724.03
|
| Rate for Payer: UHC Medicaid |
$250.70
|
| Rate for Payer: UHCCP Medicaid |
$250.70
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,074.00
|
|
|
Service Code
|
HCPCS 27632
|
| Hospital Charge Code |
27632
|
| Min. Negotiated Rate |
$250.70 |
| Max. Negotiated Rate |
$805.50 |
| Rate for Payer: Aetna Commercial |
$515.19
|
| Rate for Payer: Aetna Medicare |
$399.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.64
|
| Rate for Payer: BCBS Complete |
$263.24
|
| Rate for Payer: BCBS MAPPO |
$384.47
|
| Rate for Payer: BCN Commercial |
$623.48
|
| Rate for Payer: BCN Medicare Advantage |
$384.47
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cofinity Commercial |
$553.64
|
| Rate for Payer: Cofinity Commercial |
$515.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.47
|
| Rate for Payer: Healthscope Commercial |
$711.27
|
| Rate for Payer: Healthscope Commercial |
$615.15
|
| Rate for Payer: Mclaren Medicaid |
$250.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.69
|
| Rate for Payer: Meridian Medicaid |
$263.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$422.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.72
|
| Rate for Payer: Nomi Health Commercial |
$461.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$805.50
|
| Rate for Payer: PACE SWMI |
$384.47
|
| Rate for Payer: PHP Medicare Advantage |
$384.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$250.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$666.48
|
| Rate for Payer: Priority Health Medicare |
$384.47
|
| Rate for Payer: Priority Health SBD |
$666.48
|
| Rate for Payer: Priority Health Tiered Network |
$666.48
|
| Rate for Payer: Railroad Medicare Medicare |
$384.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.03
|
| Rate for Payer: UHC Core |
$724.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$384.47
|
| Rate for Payer: UHC Exchange |
$724.03
|
| Rate for Payer: UHC Medicaid |
$250.70
|
| Rate for Payer: UHCCP Medicaid |
$250.70
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Facility
|
IP
|
$1,074.00
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
27632
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$676.62 |
| Max. Negotiated Rate |
$966.60 |
| Rate for Payer: Aetna Commercial |
$912.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$698.10
|
| Rate for Payer: Cash Price |
$859.20
|
| Rate for Payer: Cofinity Advantage |
$751.80
|
| Rate for Payer: Cofinity Commercial |
$923.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.20
|
| Rate for Payer: Healthscope Commercial |
$966.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$805.50
|
| Rate for Payer: PHP Commercial |
$912.90
|
| Rate for Payer: Priority Health SBD |
$676.62
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>
|
Professional
|
Both
|
$1,016.00
|
|
|
Service Code
|
HCPCS 27043
|
| Min. Negotiated Rate |
$289.47 |
| Max. Negotiated Rate |
$837.52 |
| Rate for Payer: Aetna Commercial |
$597.41
|
| Rate for Payer: Aetna Medicare |
$463.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.00
|
| Rate for Payer: BCBS Complete |
$303.94
|
| Rate for Payer: BCBS MAPPO |
$445.83
|
| Rate for Payer: BCN Commercial |
$714.11
|
| Rate for Payer: BCN Medicare Advantage |
$445.83
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cash Price |
$812.80
|
| Rate for Payer: Cofinity Commercial |
$642.00
|
| Rate for Payer: Cofinity Commercial |
$597.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.83
|
| Rate for Payer: Healthscope Commercial |
$824.79
|
| Rate for Payer: Healthscope Commercial |
$713.33
|
| Rate for Payer: Mclaren Medicaid |
$289.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$468.12
|
| Rate for Payer: Meridian Medicaid |
$303.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$490.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$837.52
|
| Rate for Payer: Nomi Health Commercial |
$535.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$762.00
|
| Rate for Payer: PACE SWMI |
$445.83
|
| Rate for Payer: PHP Medicare Advantage |
$445.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$289.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.36
|
| Rate for Payer: Priority Health Medicare |
$445.83
|
| Rate for Payer: Priority Health SBD |
$763.36
|
| Rate for Payer: Priority Health Tiered Network |
$763.36
|
| Rate for Payer: Railroad Medicare Medicare |
$445.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.71
|
| Rate for Payer: UHC Core |
$824.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.83
|
| Rate for Payer: UHC Exchange |
$824.71
|
| Rate for Payer: UHC Medicaid |
$289.47
|
| Rate for Payer: UHCCP Medicaid |
$289.47
|
|
