|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$226.21 |
| Max. Negotiated Rate |
$61,006.00 |
| Rate for Payer: Aetna Commercial |
$442.88
|
| Rate for Payer: Aetna Medicare |
$343.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$475.93
|
| Rate for Payer: BCBS Complete |
$237.52
|
| Rate for Payer: BCBS MAPPO |
$330.51
|
| Rate for Payer: BCBS Trust/PPO |
$229.28
|
| Rate for Payer: BCN Commercial |
$801.43
|
| Rate for Payer: BCN Medicare Advantage |
$330.51
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$475.93
|
| Rate for Payer: Cofinity Commercial |
$442.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.51
|
| Rate for Payer: Healthscope Commercial |
$611.44
|
| Rate for Payer: Healthscope Commercial |
$528.82
|
| Rate for Payer: Mclaren Medicaid |
$226.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.04
|
| Rate for Payer: Meridian Medicaid |
$237.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,006.00
|
| Rate for Payer: Nomi Health Commercial |
$396.61
|
| Rate for Payer: PACE SWMI |
$330.51
|
| Rate for Payer: PHP Medicare Advantage |
$330.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$625.83
|
| Rate for Payer: Priority Health Medicare |
$330.51
|
| Rate for Payer: Priority Health Narrow Network |
$625.83
|
| Rate for Payer: Priority Health SBD |
$625.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.51
|
| Rate for Payer: UHC Exchange |
$395.38
|
| Rate for Payer: UHC Medicare Advantage |
$330.51
|
| Rate for Payer: UHCCP Medicaid |
$226.21
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$95,355.00 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Healthscope Commercial |
$961.98
|
| Rate for Payer: Healthscope Commercial |
$831.98
|
| Rate for Payer: Mclaren Medicaid |
$353.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,355.00
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.04
|
| Rate for Payer: Priority Health Medicare |
$519.99
|
| Rate for Payer: Priority Health Narrow Network |
$835.04
|
| Rate for Payer: Priority Health SBD |
$835.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Exchange |
$552.45
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$1,135.26 |
| Max. Negotiated Rate |
$1,621.80 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.30
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,261.40
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,261.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health SBD |
$1,135.26
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$572.98 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.51
|
| Rate for Payer: BCN Commercial |
$1,089.51
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Cofinity Commercial |
$1,261.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,261.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$1,135.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.98
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,789.78
|
| Rate for Payer: VA VA |
$3,179.00
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$353.58 |
| Max. Negotiated Rate |
$95,355.00 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.79
|
| Rate for Payer: BCBS Complete |
$371.26
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Healthscope Commercial |
$961.98
|
| Rate for Payer: Healthscope Commercial |
$831.98
|
| Rate for Payer: Mclaren Medicaid |
$353.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Meridian Medicaid |
$371.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,355.00
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.04
|
| Rate for Payer: Priority Health Medicare |
$519.99
|
| Rate for Payer: Priority Health Narrow Network |
$835.04
|
| Rate for Payer: Priority Health SBD |
$835.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Exchange |
$552.45
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UHCCP Medicaid |
$353.58
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$19,944.00 |
| Rate for Payer: Aetna Commercial |
$145.34
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.18
|
| Rate for Payer: BCBS Complete |
$76.93
|
| Rate for Payer: BCBS MAPPO |
$108.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.78
|
| Rate for Payer: BCN Commercial |
$314.22
|
| Rate for Payer: BCN Medicare Advantage |
$108.46
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$145.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.46
|
| Rate for Payer: Healthscope Commercial |
$200.65
|
| Rate for Payer: Healthscope Commercial |
$173.54
|
| Rate for Payer: Mclaren Medicaid |
$73.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.88
|
| Rate for Payer: Meridian Medicaid |
$76.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,944.00
|
| Rate for Payer: Nomi Health Commercial |
$130.15
|
| Rate for Payer: PACE SWMI |
$108.46
|
| Rate for Payer: PHP Medicare Advantage |
$108.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.64
|
| Rate for Payer: Priority Health Medicare |
$108.46
|
| Rate for Payer: Priority Health Narrow Network |
$204.64
|
| Rate for Payer: Priority Health SBD |
$204.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.46
|
| Rate for Payer: UHC Exchange |
$224.37
|
| Rate for Payer: UHC Medicare Advantage |
$108.46
|
| Rate for Payer: UHCCP Medicaid |
$73.27
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$112,010.00 |
| Rate for Payer: Aetna Commercial |
$812.52
|
| Rate for Payer: Aetna Medicare |
$630.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.16
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$606.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$933.86
|
| Rate for Payer: BCN Medicare Advantage |
$606.36
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$873.16
|
| Rate for Payer: Cofinity Commercial |
$812.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.36
|
| Rate for Payer: Healthscope Commercial |
$970.18
|
| Rate for Payer: Healthscope Commercial |
$1,121.77
|
| Rate for Payer: Mclaren Medicaid |
$412.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.68
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112,010.00
|
| Rate for Payer: Nomi Health Commercial |
$727.63
|
| Rate for Payer: PACE SWMI |
$606.36
|
| Rate for Payer: PHP Medicare Advantage |
$606.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.36
|
| Rate for Payer: Priority Health Medicare |
$606.36
|
| Rate for Payer: Priority Health Narrow Network |
$867.36
|
| Rate for Payer: Priority Health SBD |
$867.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.36
|
| Rate for Payer: UHC Exchange |
$552.50
|
| Rate for Payer: UHC Medicare Advantage |
$606.36
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$205,931.00 |
| Rate for Payer: Aetna Commercial |
$1,494.66
|
| Rate for Payer: Aetna Medicare |
$1,160.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,606.20
|
| Rate for Payer: BCBS Complete |
$788.14
|
| Rate for Payer: BCBS MAPPO |
$1,115.42
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$1,702.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,115.42
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,606.20
|
| Rate for Payer: Cofinity Commercial |
$1,494.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,115.42
|
| Rate for Payer: Healthscope Commercial |
$2,063.53
|
| Rate for Payer: Healthscope Commercial |
$1,784.67
|
| Rate for Payer: Mclaren Medicaid |
$750.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,171.19
|
| Rate for Payer: Meridian Medicaid |
$788.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205,931.00
|
| Rate for Payer: Nomi Health Commercial |
$1,338.50
|
| Rate for Payer: PACE SWMI |
$1,115.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,115.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$750.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,611.01
|
| Rate for Payer: Priority Health Medicare |
$1,115.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,611.01
|
| Rate for Payer: Priority Health SBD |
$1,611.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,176.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,115.42
|
| Rate for Payer: UHC Exchange |
$1,176.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,115.42
|
| Rate for Payer: UHCCP Medicaid |
$750.61
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$95,351.00 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.08
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Healthscope Commercial |
$831.20
|
| Rate for Payer: Healthscope Commercial |
$961.08
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,351.00
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.96
|
| Rate for Payer: Priority Health Medicare |
$519.50
|
| Rate for Payer: Priority Health Narrow Network |
$830.96
|
| Rate for Payer: Priority Health SBD |
$830.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$95,351.00 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.08
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Healthscope Commercial |
$831.20
|
| Rate for Payer: Healthscope Commercial |
$961.08
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95,351.00
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$830.96
|
| Rate for Payer: Priority Health Medicare |
$519.50
|
| Rate for Payer: Priority Health Narrow Network |
$830.96
|
| Rate for Payer: Priority Health SBD |
$830.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$572.56 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.65
|
| Rate for Payer: BCN Commercial |
$1,075.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Cofinity Commercial |
$1,559.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,559.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$1,403.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.56
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$1,403.64 |
| Max. Negotiated Rate |
$2,005.20 |
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.20
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,559.60
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,559.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health SBD |
$1,403.64
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$480.00 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,572.01
|
| Rate for Payer: BCN Commercial |
$1,572.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$863.10
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$863.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$776.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.00
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$79,697.00 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.84
|
| Rate for Payer: BCBS Complete |
$305.51
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Healthscope Commercial |
$694.27
|
| Rate for Payer: Healthscope Commercial |
$802.75
|
| Rate for Payer: Mclaren Medicaid |
$290.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Meridian Medicaid |
$305.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,697.00
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.02
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: Priority Health Narrow Network |
$690.02
|
| Rate for Payer: Priority Health SBD |
$690.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP Medicaid |
$290.96
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$79,697.00 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.84
|
| Rate for Payer: BCBS Complete |
$305.51
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Healthscope Commercial |
$694.27
|
| Rate for Payer: Healthscope Commercial |
$802.75
|
| Rate for Payer: Mclaren Medicaid |
$290.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Meridian Medicaid |
$305.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,697.00
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.02
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: Priority Health Narrow Network |
$690.02
|
| Rate for Payer: Priority Health SBD |
$690.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP Medicaid |
$290.96
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$776.79 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.45
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Cofinity Commercial |
$863.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$863.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health SBD |
$776.79
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$746.55 |
| Max. Negotiated Rate |
$1,066.50 |
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Cofinity Commercial |
$829.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$829.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health SBD |
$746.55
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$131,692.00 |
| Rate for Payer: Aetna Commercial |
$958.44
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.44
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Healthscope Commercial |
$1,144.40
|
| Rate for Payer: Healthscope Commercial |
$1,323.21
|
| Rate for Payer: Mclaren Medicaid |
$477.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,692.00
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: Priority Health SBD |
$1,134.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$746.55 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,543.56
|
| Rate for Payer: BCN Commercial |
$1,543.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$829.50
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$829.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.80
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$131,692.00 |
| Rate for Payer: Aetna Commercial |
$958.44
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.44
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Healthscope Commercial |
$1,144.40
|
| Rate for Payer: Healthscope Commercial |
$1,323.21
|
| Rate for Payer: Mclaren Medicaid |
$477.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,692.00
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: Priority Health SBD |
$1,134.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$710.01 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Cofinity Commercial |
$1,410.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$1,269.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$710.01
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$118,600.00 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.17
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Healthscope Commercial |
$1,031.30
|
| Rate for Payer: Healthscope Commercial |
$1,192.44
|
| Rate for Payer: Mclaren Medicaid |
$431.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,600.00
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.75
|
| Rate for Payer: Priority Health SBD |
$1,019.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,269.45 |
| Max. Negotiated Rate |
$1,813.50 |
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,410.50
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health SBD |
$1,269.45
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$118,600.00 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.17
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Healthscope Commercial |
$1,031.30
|
| Rate for Payer: Healthscope Commercial |
$1,192.44
|
| Rate for Payer: Mclaren Medicaid |
$431.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,600.00
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.75
|
| Rate for Payer: Priority Health SBD |
$1,019.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$556.29 |
| Max. Negotiated Rate |
$794.70 |
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.95
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$618.10
|
| Rate for Payer: Cofinity Commercial |
$759.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Healthscope Commercial |
$794.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: PHP Commercial |
$750.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health SBD |
$556.29
|
|
