|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,635.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,030.05 |
| Max. Negotiated Rate |
$1,471.50 |
| Rate for Payer: Aetna Commercial |
$1,389.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,062.75
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Advantage |
$1,144.50
|
| Rate for Payer: Cofinity Commercial |
$1,406.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.00
|
| Rate for Payer: Healthscope Commercial |
$1,471.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PHP Commercial |
$1,389.75
|
| Rate for Payer: Priority Health SBD |
$1,030.05
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,635.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$420.04 |
| Max. Negotiated Rate |
$1,241.14 |
| Rate for Payer: Aetna Commercial |
$866.24
|
| Rate for Payer: Aetna Medicare |
$672.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$866.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$930.89
|
| Rate for Payer: BCBS Complete |
$441.04
|
| Rate for Payer: BCBS MAPPO |
$646.45
|
| Rate for Payer: BCN Commercial |
$1,059.21
|
| Rate for Payer: BCN Medicare Advantage |
$646.45
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$930.89
|
| Rate for Payer: Cofinity Commercial |
$866.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.45
|
| Rate for Payer: Healthscope Commercial |
$1,195.93
|
| Rate for Payer: Healthscope Commercial |
$1,034.32
|
| Rate for Payer: Mclaren Medicaid |
$420.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.77
|
| Rate for Payer: Meridian Medicaid |
$441.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$711.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,241.14
|
| Rate for Payer: Nomi Health Commercial |
$775.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PACE SWMI |
$646.45
|
| Rate for Payer: PHP Medicare Advantage |
$646.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,132.26
|
| Rate for Payer: Priority Health Medicare |
$646.45
|
| Rate for Payer: Priority Health SBD |
$1,132.26
|
| Rate for Payer: Priority Health Tiered Network |
$1,132.26
|
| Rate for Payer: Railroad Medicare Medicare |
$646.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,221.58
|
| Rate for Payer: UHC Core |
$1,221.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$646.45
|
| Rate for Payer: UHC Exchange |
$1,221.58
|
| Rate for Payer: UHC Medicaid |
$420.04
|
| Rate for Payer: UHCCP Medicaid |
$420.04
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,374.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,530.50 |
| Rate for Payer: PHP Medicare Advantage |
$702.00
|
| Rate for Payer: Aetna Commercial |
$940.68
|
| Rate for Payer: Aetna Medicare |
$730.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$940.68
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$702.00
|
| Rate for Payer: BCN Commercial |
$1,146.36
|
| Rate for Payer: BCN Medicare Advantage |
$702.00
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cofinity Commercial |
$940.68
|
| Rate for Payer: Cofinity Commercial |
$1,010.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.00
|
| Rate for Payer: Healthscope Commercial |
$1,298.70
|
| Rate for Payer: Healthscope Commercial |
$1,123.20
|
| Rate for Payer: Mclaren Medicaid |
$455.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.10
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$772.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,341.49
|
| Rate for Payer: Nomi Health Commercial |
$842.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,530.50
|
| Rate for Payer: PACE SWMI |
$702.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,225.42
|
| Rate for Payer: Priority Health Medicare |
$702.00
|
| Rate for Payer: Priority Health SBD |
$1,225.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,225.42
|
| Rate for Payer: Railroad Medicare Medicare |
$702.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,326.96
|
| Rate for Payer: UHC Core |
$1,326.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$702.00
|
| Rate for Payer: UHC Exchange |
$1,326.96
|
| Rate for Payer: UHC Medicaid |
$455.61
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$774.61
|
| Rate for Payer: Aetna Medicare |
$601.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$774.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$832.42
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCBS MAPPO |
$578.07
|
| Rate for Payer: BCN Commercial |
$948.65
|
| Rate for Payer: BCN Medicare Advantage |
$578.07
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cofinity Commercial |
$832.42
|
| Rate for Payer: Cofinity Commercial |
$774.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.07
|
| Rate for Payer: Healthscope Commercial |
$924.91
|
| Rate for Payer: Healthscope Commercial |
$1,069.43
|
| Rate for Payer: Mclaren Medicaid |
$376.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.97
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,110.49
|
| Rate for Payer: Nomi Health Commercial |
$693.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.00
|
| Rate for Payer: PACE SWMI |
$578.07
|
| Rate for Payer: PHP Medicare Advantage |
$578.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,014.08
|
| Rate for Payer: Priority Health Medicare |
$578.07
|
| Rate for Payer: Priority Health SBD |
$1,014.08
|
| Rate for Payer: Priority Health Tiered Network |
$1,014.08
|
| Rate for Payer: Railroad Medicare Medicare |
$578.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,092.39
|
| Rate for Payer: UHC Core |
$1,092.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$578.07
|
| Rate for Payer: UHC Exchange |
$1,092.39
|
| Rate for Payer: UHC Medicaid |
$376.37
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,604.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,010.52 |
| Max. Negotiated Rate |
$1,443.60 |
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.60
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Advantage |
$1,122.80
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,363.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| Rate for Payer: Priority Health SBD |
$1,010.52
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$513.64
|
| Rate for Payer: Aetna Medicare |
$398.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.97
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$383.31
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: BCN Medicare Advantage |
$383.31
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$551.97
|
| Rate for Payer: Cofinity Commercial |
$513.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.31
|
| Rate for Payer: Healthscope Commercial |
$709.12
|
| Rate for Payer: Healthscope Commercial |
$613.30
|
| Rate for Payer: Mclaren Medicaid |
$249.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.48
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$421.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$721.76
|
| Rate for Payer: Nomi Health Commercial |
$459.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE SWMI |
$383.31
|
| Rate for Payer: PHP Medicare Advantage |
$383.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$661.69
|
| Rate for Payer: Priority Health Medicare |
$383.31
|
| Rate for Payer: Priority Health SBD |
$661.69
|
| Rate for Payer: Priority Health Tiered Network |
$661.69
|
| Rate for Payer: Railroad Medicare Medicare |
$383.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.00
|
| Rate for Payer: UHC Core |
$711.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$383.31
|
| Rate for Payer: UHC Exchange |
$711.00
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$513.64
|
| Rate for Payer: Aetna Medicare |
$398.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.97
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$383.31
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: BCN Medicare Advantage |
$383.31
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$551.97
|
| Rate for Payer: Cofinity Commercial |
$513.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.31
|
| Rate for Payer: Healthscope Commercial |
$709.12
|
| Rate for Payer: Healthscope Commercial |
$613.30
|
| Rate for Payer: Mclaren Medicaid |
$249.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.48
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$421.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$721.76
|
| Rate for Payer: Nomi Health Commercial |
$459.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE SWMI |
$383.31
|
| Rate for Payer: PHP Medicare Advantage |
$383.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$661.69
|
| Rate for Payer: Priority Health Medicare |
$383.31
|
| Rate for Payer: Priority Health SBD |
$661.69
|
| Rate for Payer: Priority Health Tiered Network |
$661.69
|
| Rate for Payer: Railroad Medicare Medicare |
$383.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.00
|
| Rate for Payer: UHC Core |
$711.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$383.31
|
| Rate for Payer: UHC Exchange |
$711.00
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,604.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,010.52 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,042.60
|
| 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 |
$1,755.84
|
| Rate for Payer: BCN Commercial |
$1,755.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Advantage |
$1,122.80
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| 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 |
$1,363.40
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| 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 |
$1,010.52
|
| 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 EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$417.07
|
| Rate for Payer: Aetna Medicare |
$323.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.20
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$311.25
|
| Rate for Payer: BCN Commercial |
$505.45
|
| Rate for Payer: BCN Medicare Advantage |
$311.25
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$448.20
|
| Rate for Payer: Cofinity Commercial |
$417.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.25
|
| Rate for Payer: Healthscope Commercial |
$575.81
|
| Rate for Payer: Healthscope Commercial |
$498.00
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.81
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.43
|
| Rate for Payer: Nomi Health Commercial |
$373.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$311.25
|
| Rate for Payer: PHP Medicare Advantage |
$311.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$540.32
|
| Rate for Payer: Priority Health Medicare |
$311.25
|
| Rate for Payer: Priority Health SBD |
$540.32
|
| Rate for Payer: Priority Health Tiered Network |
$540.32
|
| Rate for Payer: Railroad Medicare Medicare |
$311.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.35
|
| Rate for Payer: UHC Core |
$571.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.25
|
| Rate for Payer: UHC Exchange |
$571.35
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$417.07
|
| Rate for Payer: Aetna Medicare |
$323.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.20
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$311.25
|
| Rate for Payer: BCN Commercial |
$505.45
|
| Rate for Payer: BCN Medicare Advantage |
$311.25
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$448.20
|
| Rate for Payer: Cofinity Commercial |
$417.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.25
|
| Rate for Payer: Healthscope Commercial |
$575.81
|
| Rate for Payer: Healthscope Commercial |
$498.00
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.81
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.43
|
| Rate for Payer: Nomi Health Commercial |
$373.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$311.25
|
| Rate for Payer: PHP Medicare Advantage |
$311.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$540.32
|
| Rate for Payer: Priority Health Medicare |
$311.25
|
| Rate for Payer: Priority Health SBD |
$540.32
|
| Rate for Payer: Priority Health Tiered Network |
$540.32
|
| Rate for Payer: Railroad Medicare Medicare |
$311.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.35
|
| Rate for Payer: UHC Core |
$571.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.25
|
| Rate for Payer: UHC Exchange |
$571.35
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,336.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$841.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,135.60
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.40
|
| 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 |
$984.16
|
| Rate for Payer: BCN Commercial |
$984.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Advantage |
$935.20
|
| Rate for Payer: Cofinity Commercial |
$1,148.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,202.40
|
| 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 |
$1,135.60
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,135.60
|
| 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 |
$841.68
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$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 EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,336.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$841.68 |
| Max. Negotiated Rate |
$1,202.40 |
| Rate for Payer: Aetna Commercial |
$1,135.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.40
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Advantage |
$935.20
|
| Rate for Payer: Cofinity Commercial |
$1,148.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.80
|
| Rate for Payer: Healthscope Commercial |
$1,202.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,135.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PHP Commercial |
$1,135.60
|
| Rate for Payer: Priority Health SBD |
$841.68
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$416.63 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$859.52
|
| Rate for Payer: Aetna Medicare |
$667.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.66
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCBS MAPPO |
$641.43
|
| Rate for Payer: BCN Commercial |
$1,054.73
|
| Rate for Payer: BCN Medicare Advantage |
$641.43
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$923.66
|
| Rate for Payer: Cofinity Commercial |
$859.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.43
|
| Rate for Payer: Healthscope Commercial |
$1,186.65
|
| Rate for Payer: Healthscope Commercial |
$1,026.29
|
| Rate for Payer: Mclaren Medicaid |
$416.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.50
|
| Rate for Payer: Meridian Medicaid |
$437.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,233.97
|
| Rate for Payer: Nomi Health Commercial |
$769.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PACE SWMI |
$641.43
|
| Rate for Payer: PHP Medicare Advantage |
$641.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,127.47
|
| Rate for Payer: Priority Health Medicare |
$641.43
|
| Rate for Payer: Priority Health SBD |
$1,127.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$641.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,221.53
|
| Rate for Payer: UHC Core |
$1,221.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.43
|
| Rate for Payer: UHC Exchange |
$1,221.53
|
| Rate for Payer: UHC Medicaid |
$416.63
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,744.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,098.72 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$1,482.40
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.60
|
| 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 |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Advantage |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,499.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,395.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,569.60
|
| 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 |
$1,482.40
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$1,482.40
|
| 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 |
$1,098.72
|
| 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 EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,744.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,098.72 |
| Max. Negotiated Rate |
$1,569.60 |
| Rate for Payer: Aetna Commercial |
$1,482.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Advantage |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,499.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,395.20
|
| Rate for Payer: Healthscope Commercial |
$1,569.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,482.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PHP Commercial |
$1,482.40
|
| Rate for Payer: Priority Health SBD |
$1,098.72
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$416.63 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$859.52
|
| Rate for Payer: Aetna Medicare |
$667.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$859.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.66
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCBS MAPPO |
$641.43
|
| Rate for Payer: BCN Commercial |
$1,054.73
|
| Rate for Payer: BCN Medicare Advantage |
$641.43
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$923.66
|
| Rate for Payer: Cofinity Commercial |
$859.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.43
|
| Rate for Payer: Healthscope Commercial |
$1,186.65
|
| Rate for Payer: Healthscope Commercial |
$1,026.29
|
| Rate for Payer: Mclaren Medicaid |
$416.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.50
|
| Rate for Payer: Meridian Medicaid |
$437.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,233.97
|
| Rate for Payer: Nomi Health Commercial |
$769.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PACE SWMI |
$641.43
|
| Rate for Payer: PHP Medicare Advantage |
$641.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,127.47
|
| Rate for Payer: Priority Health Medicare |
$641.43
|
| Rate for Payer: Priority Health SBD |
$1,127.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$641.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,221.53
|
| Rate for Payer: UHC Core |
$1,221.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.43
|
| Rate for Payer: UHC Exchange |
$1,221.53
|
| Rate for Payer: UHC Medicaid |
$416.63
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$1,190.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$749.70 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$1,011.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.50
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Advantage |
$833.00
|
| Rate for Payer: Cofinity Commercial |
$1,023.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$952.00
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PHP Commercial |
$1,011.50
|
| Rate for Payer: Priority Health SBD |
$749.70
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
24076
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$973.15 |
| Rate for Payer: Aetna Commercial |
$680.67
|
| Rate for Payer: Aetna Medicare |
$528.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.46
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCBS MAPPO |
$507.96
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: BCN Medicare Advantage |
$507.96
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$731.46
|
| Rate for Payer: Cofinity Commercial |
$680.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.96
|
| Rate for Payer: Healthscope Commercial |
$939.73
|
| Rate for Payer: Healthscope Commercial |
$812.74
|
| Rate for Payer: Mclaren Medicaid |
$332.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.36
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$558.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.15
|
| Rate for Payer: Nomi Health Commercial |
$609.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$507.96
|
| Rate for Payer: PHP Medicare Advantage |
$507.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$894.31
|
| Rate for Payer: Priority Health Medicare |
$507.96
|
| Rate for Payer: Priority Health SBD |
$894.31
|
| Rate for Payer: Priority Health Tiered Network |
$894.31
|
| Rate for Payer: Railroad Medicare Medicare |
$507.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$948.98
|
| Rate for Payer: UHC Core |
$948.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$507.96
|
| Rate for Payer: UHC Exchange |
$948.98
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$1,190.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$749.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$1,011.50
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.50
|
| 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 |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Advantage |
$833.00
|
| Rate for Payer: Cofinity Commercial |
$1,023.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$952.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| 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 |
$1,011.50
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$1,011.50
|
| 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 |
$749.70
|
| 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 EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$973.15 |
| Rate for Payer: Aetna Commercial |
$680.67
|
| Rate for Payer: Aetna Medicare |
$528.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.46
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCBS MAPPO |
$507.96
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: BCN Medicare Advantage |
$507.96
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$731.46
|
| Rate for Payer: Cofinity Commercial |
$680.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.96
|
| Rate for Payer: Healthscope Commercial |
$939.73
|
| Rate for Payer: Healthscope Commercial |
$812.74
|
| Rate for Payer: Mclaren Medicaid |
$332.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.36
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$558.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.15
|
| Rate for Payer: Nomi Health Commercial |
$609.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$507.96
|
| Rate for Payer: PHP Medicare Advantage |
$507.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$894.31
|
| Rate for Payer: Priority Health Medicare |
$507.96
|
| Rate for Payer: Priority Health SBD |
$894.31
|
| Rate for Payer: Priority Health Tiered Network |
$894.31
|
| Rate for Payer: Railroad Medicare Medicare |
$507.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$948.98
|
| Rate for Payer: UHC Core |
$948.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$507.96
|
| Rate for Payer: UHC Exchange |
$948.98
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$415.39
|
| Rate for Payer: Aetna Medicare |
$322.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.39
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$309.99
|
| Rate for Payer: BCN Commercial |
$514.42
|
| Rate for Payer: BCN Medicare Advantage |
$309.99
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$446.39
|
| Rate for Payer: Cofinity Commercial |
$415.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.99
|
| Rate for Payer: Healthscope Commercial |
$573.48
|
| Rate for Payer: Healthscope Commercial |
$495.98
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.49
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.86
|
| Rate for Payer: Nomi Health Commercial |
$371.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE SWMI |
$309.99
|
| Rate for Payer: PHP Medicare Advantage |
$309.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$309.99
|
| Rate for Payer: Priority Health SBD |
$549.90
|
| Rate for Payer: Priority Health Tiered Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$309.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.26
|
| Rate for Payer: UHC Core |
$571.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.99
|
| Rate for Payer: UHC Exchange |
$571.26
|
| Rate for Payer: UHC Medicaid |
$204.91
|
| Rate for Payer: UHCCP Medicaid |
$204.91
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$706.86 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Advantage |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health SBD |
$706.86
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$706.86 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| 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 |
$1,119.89
|
| Rate for Payer: BCN Commercial |
$1,119.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Advantage |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| 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 |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$953.70
|
| 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 |
$706.86
|
| 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 EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$415.39
|
| Rate for Payer: Aetna Medicare |
$322.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.39
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$309.99
|
| Rate for Payer: BCN Commercial |
$514.42
|
| Rate for Payer: BCN Medicare Advantage |
$309.99
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$446.39
|
| Rate for Payer: Cofinity Commercial |
$415.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.99
|
| Rate for Payer: Healthscope Commercial |
$573.48
|
| Rate for Payer: Healthscope Commercial |
$495.98
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.49
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.86
|
| Rate for Payer: Nomi Health Commercial |
$371.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE SWMI |
$309.99
|
| Rate for Payer: PHP Medicare Advantage |
$309.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$309.99
|
| Rate for Payer: Priority Health SBD |
$549.90
|
| Rate for Payer: Priority Health Tiered Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$309.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.26
|
| Rate for Payer: UHC Core |
$571.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.99
|
| Rate for Payer: UHC Exchange |
$571.26
|
| Rate for Payer: UHC Medicaid |
$204.91
|
| Rate for Payer: UHCCP Medicaid |
$204.91
|
|
|
PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$1,297.50 |
| Rate for Payer: PHP Medicare Advantage |
$479.13
|
| Rate for Payer: Aetna Commercial |
$642.03
|
| Rate for Payer: Aetna Medicare |
$498.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$689.95
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS MAPPO |
$479.13
|
| Rate for Payer: BCN Commercial |
$809.22
|
| Rate for Payer: BCN Medicare Advantage |
$479.13
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$689.95
|
| Rate for Payer: Cofinity Commercial |
$642.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.13
|
| Rate for Payer: Healthscope Commercial |
$886.39
|
| Rate for Payer: Healthscope Commercial |
$766.61
|
| Rate for Payer: Mclaren Medicaid |
$315.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.09
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$527.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.04
|
| Rate for Payer: Nomi Health Commercial |
$574.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$479.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$865.03
|
| Rate for Payer: Priority Health Medicare |
$479.13
|
| Rate for Payer: Priority Health SBD |
$865.03
|
| Rate for Payer: Priority Health Tiered Network |
$865.03
|
| Rate for Payer: Railroad Medicare Medicare |
$479.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$911.71
|
| Rate for Payer: UHC Core |
$911.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$479.13
|
| Rate for Payer: UHC Exchange |
$911.71
|
| Rate for Payer: UHC Medicaid |
$315.03
|
| Rate for Payer: UHCCP Medicaid |
$315.03
|
|
