|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$92,385.00 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.17
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Healthscope Commercial |
$800.19
|
| Rate for Payer: Healthscope Commercial |
$925.22
|
| Rate for Payer: Mclaren Medicaid |
$338.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Meridian Medicaid |
$355.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92,385.00
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.99
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: Priority Health Narrow Network |
$802.99
|
| Rate for Payer: Priority Health SBD |
$802.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$553.39 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.95
|
| 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 |
$1,438.95
|
| Rate for Payer: BCN Commercial |
$1,438.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$759.38
|
| Rate for Payer: Cofinity Commercial |
$618.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$794.70
|
| 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 |
$750.55
|
| 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 |
$750.55
|
| 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 |
$573.95
|
| 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 |
$556.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.39
|
| Rate for Payer: UHC Core |
$1,463.00
|
| 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 FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$92,385.00 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.17
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Healthscope Commercial |
$800.19
|
| Rate for Payer: Healthscope Commercial |
$925.22
|
| Rate for Payer: Mclaren Medicaid |
$338.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Meridian Medicaid |
$355.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92,385.00
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.99
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: Priority Health Narrow Network |
$802.99
|
| Rate for Payer: Priority Health SBD |
$802.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$260.50 |
| Max. Negotiated Rate |
$71,091.00 |
| Rate for Payer: Aetna Commercial |
$514.61
|
| Rate for Payer: Aetna Medicare |
$399.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.02
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS MAPPO |
$384.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$789.70
|
| Rate for Payer: BCN Medicare Advantage |
$384.04
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$553.02
|
| Rate for Payer: Cofinity Commercial |
$514.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.04
|
| Rate for Payer: Healthscope Commercial |
$614.46
|
| Rate for Payer: Healthscope Commercial |
$710.47
|
| Rate for Payer: Mclaren Medicaid |
$260.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.24
|
| Rate for Payer: Meridian Medicaid |
$273.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71,091.00
|
| Rate for Payer: Nomi Health Commercial |
$460.85
|
| Rate for Payer: PACE SWMI |
$384.04
|
| Rate for Payer: PHP Medicare Advantage |
$384.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.29
|
| Rate for Payer: Priority Health Medicare |
$384.04
|
| Rate for Payer: Priority Health Narrow Network |
$619.29
|
| Rate for Payer: Priority Health SBD |
$619.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.04
|
| Rate for Payer: UHC Medicare Advantage |
$384.04
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$171.70 |
| Max. Negotiated Rate |
$75,438.00 |
| Rate for Payer: Aetna Commercial |
$551.34
|
| Rate for Payer: Aetna Medicare |
$427.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.49
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$411.45
|
| Rate for Payer: BCBS Trust/PPO |
$171.70
|
| Rate for Payer: BCN Commercial |
$624.04
|
| Rate for Payer: BCN Medicare Advantage |
$411.45
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cofinity Commercial |
$592.49
|
| Rate for Payer: Cofinity Commercial |
$551.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.45
|
| Rate for Payer: Healthscope Commercial |
$658.32
|
| Rate for Payer: Healthscope Commercial |
$761.18
|
| Rate for Payer: Mclaren Medicaid |
$277.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.02
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75,438.00
|
| Rate for Payer: Nomi Health Commercial |
$493.74
|
| Rate for Payer: PACE SWMI |
$411.45
|
| Rate for Payer: PHP Medicare Advantage |
$411.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$656.94
|
| Rate for Payer: Priority Health Medicare |
$411.45
|
| Rate for Payer: Priority Health Narrow Network |
$656.94
|
| Rate for Payer: Priority Health SBD |
$656.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.45
|
| Rate for Payer: UHC Medicare Advantage |
$411.45
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$235.09 |
| Max. Negotiated Rate |
$92,189.00 |
| Rate for Payer: Aetna Commercial |
$672.95
|
| Rate for Payer: Aetna Medicare |
$522.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.17
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$502.20
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$767.22
|
| Rate for Payer: BCN Medicare Advantage |
$502.20
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$723.17
|
| Rate for Payer: Cofinity Commercial |
$672.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.20
|
| Rate for Payer: Healthscope Commercial |
$929.07
|
| Rate for Payer: Healthscope Commercial |
$803.52
|
| Rate for Payer: Mclaren Medicaid |
$341.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.31
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92,189.00
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PACE SWMI |
$502.20
|
| Rate for Payer: PHP Medicare Advantage |
$502.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$806.03
|
| Rate for Payer: Priority Health Medicare |
$502.20
|
| Rate for Payer: Priority Health Narrow Network |
$806.03
|
| Rate for Payer: Priority Health SBD |
$806.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.20
|
| Rate for Payer: UHC Exchange |
$698.50
|
| Rate for Payer: UHC Medicare Advantage |
$502.20
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,092.42 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,213.80
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health SBD |
$1,092.42
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$94,390.00 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.14
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Healthscope Commercial |
$943.17
|
| Rate for Payer: Healthscope Commercial |
$815.71
|
| Rate for Payer: Mclaren Medicaid |
$343.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,390.00
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.21
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: Priority Health Narrow Network |
$816.21
|
| Rate for Payer: Priority Health SBD |
$816.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Exchange |
$468.42
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$565.03 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| 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 |
$1,522.58
|
| Rate for Payer: BCN Commercial |
$1,522.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Cofinity Commercial |
$1,213.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| 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 |
$1,473.90
|
| 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 |
$1,473.90
|
| 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 |
$1,127.10
|
| 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 |
$1,092.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.03
|
| 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 NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$94,390.00 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.14
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Healthscope Commercial |
$943.17
|
| Rate for Payer: Healthscope Commercial |
$815.71
|
| Rate for Payer: Mclaren Medicaid |
$343.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94,390.00
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.21
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: Priority Health Narrow Network |
$816.21
|
| Rate for Payer: Priority Health SBD |
$816.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Exchange |
$468.42
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$96,599.00 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.86
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Healthscope Commercial |
$976.21
|
| Rate for Payer: Healthscope Commercial |
$844.29
|
| Rate for Payer: Mclaren Medicaid |
$356.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96,599.00
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.13
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: Priority Health Narrow Network |
$840.13
|
| Rate for Payer: Priority Health SBD |
$840.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Exchange |
$657.88
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$96,599.00 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.86
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Healthscope Commercial |
$976.21
|
| Rate for Payer: Healthscope Commercial |
$844.29
|
| Rate for Payer: Mclaren Medicaid |
$356.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96,599.00
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.13
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: Priority Health Narrow Network |
$840.13
|
| Rate for Payer: Priority Health SBD |
$840.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Exchange |
$657.88
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$643.86 |
| Max. Negotiated Rate |
$919.80 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health SBD |
$643.86
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$580.98 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| 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 |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| 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 |
$868.70
|
| 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 |
$868.70
|
| 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 |
$664.30
|
| 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 |
$643.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.98
|
| 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 TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$100,849.00 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.90
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Healthscope Commercial |
$879.89
|
| Rate for Payer: Healthscope Commercial |
$1,017.37
|
| Rate for Payer: Mclaren Medicaid |
$368.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100,849.00
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$549.93
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: Priority Health SBD |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Exchange |
$453.40
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$100,849.00 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.90
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Healthscope Commercial |
$879.89
|
| Rate for Payer: Healthscope Commercial |
$1,017.37
|
| Rate for Payer: Mclaren Medicaid |
$368.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100,849.00
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$549.93
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: Priority Health SBD |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Exchange |
$453.40
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$607.82 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$986.85
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.65
|
| 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 |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$998.46
|
| Rate for Payer: Cofinity Commercial |
$812.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$812.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,044.90
|
| 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 |
$986.85
|
| 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 |
$986.85
|
| 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 |
$754.65
|
| 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 |
$731.43
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.82
|
| 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 TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$731.43 |
| Max. Negotiated Rate |
$1,044.90 |
| Rate for Payer: Aetna Commercial |
$986.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.65
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$812.70
|
| Rate for Payer: Cofinity Commercial |
$998.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$812.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Healthscope Commercial |
$1,044.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.85
|
| Rate for Payer: PHP Commercial |
$986.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health SBD |
$731.43
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,203.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$132.44 |
| Max. Negotiated Rate |
$118,910.00 |
| Rate for Payer: Aetna Commercial |
$868.23
|
| Rate for Payer: Aetna Medicare |
$673.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.02
|
| Rate for Payer: BCBS Complete |
$454.23
|
| Rate for Payer: BCBS MAPPO |
$647.93
|
| Rate for Payer: BCBS Trust/PPO |
$132.44
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$647.93
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cofinity Commercial |
$933.02
|
| Rate for Payer: Cofinity Commercial |
$868.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.93
|
| Rate for Payer: Healthscope Commercial |
$1,036.69
|
| Rate for Payer: Healthscope Commercial |
$1,198.67
|
| Rate for Payer: Mclaren Medicaid |
$432.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.33
|
| Rate for Payer: Meridian Medicaid |
$454.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118,910.00
|
| Rate for Payer: Nomi Health Commercial |
$777.52
|
| Rate for Payer: PACE SWMI |
$647.93
|
| Rate for Payer: PHP Medicare Advantage |
$647.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.35
|
| Rate for Payer: Priority Health Medicare |
$647.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.35
|
| Rate for Payer: Priority Health SBD |
$1,025.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.93
|
| Rate for Payer: UHC Medicare Advantage |
$647.93
|
| Rate for Payer: UHCCP Medicaid |
$432.60
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$78,581.00 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$445.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.56
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS MAPPO |
$428.17
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: BCN Medicare Advantage |
$428.17
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$616.56
|
| Rate for Payer: Cofinity Commercial |
$573.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.17
|
| Rate for Payer: Healthscope Commercial |
$685.07
|
| Rate for Payer: Healthscope Commercial |
$792.11
|
| Rate for Payer: Mclaren Medicaid |
$286.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.58
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,581.00
|
| Rate for Payer: Nomi Health Commercial |
$513.80
|
| Rate for Payer: PACE SWMI |
$428.17
|
| Rate for Payer: PHP Medicare Advantage |
$428.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.33
|
| Rate for Payer: Priority Health Medicare |
$428.17
|
| Rate for Payer: Priority Health Narrow Network |
$679.33
|
| Rate for Payer: Priority Health SBD |
$679.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.17
|
| Rate for Payer: UHC Medicare Advantage |
$428.17
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$78,581.00 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$445.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.56
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS MAPPO |
$428.17
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: BCN Medicare Advantage |
$428.17
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$616.56
|
| Rate for Payer: Cofinity Commercial |
$573.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.17
|
| Rate for Payer: Healthscope Commercial |
$685.07
|
| Rate for Payer: Healthscope Commercial |
$792.11
|
| Rate for Payer: Mclaren Medicaid |
$286.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.58
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,581.00
|
| Rate for Payer: Nomi Health Commercial |
$513.80
|
| Rate for Payer: PACE SWMI |
$428.17
|
| Rate for Payer: PHP Medicare Advantage |
$428.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.33
|
| Rate for Payer: Priority Health Medicare |
$428.17
|
| Rate for Payer: Priority Health Narrow Network |
$679.33
|
| Rate for Payer: Priority Health SBD |
$679.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.17
|
| Rate for Payer: UHC Medicare Advantage |
$428.17
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$449.82 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health SBD |
$449.82
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$449.82 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| 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 |
$1,519.94
|
| Rate for Payer: BCN Commercial |
$1,519.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| 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 |
$606.90
|
| 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 |
$606.90
|
| 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 |
$464.10
|
| 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 |
$449.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.26
|
| 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 TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$216.50 |
| Max. Negotiated Rate |
$59,161.00 |
| Rate for Payer: Aetna Commercial |
$433.09
|
| Rate for Payer: Aetna Medicare |
$336.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.41
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$323.20
|
| Rate for Payer: BCBS Trust/PPO |
$216.50
|
| Rate for Payer: BCN Commercial |
$694.90
|
| Rate for Payer: BCN Medicare Advantage |
$323.20
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$465.41
|
| Rate for Payer: Cofinity Commercial |
$433.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.20
|
| Rate for Payer: Healthscope Commercial |
$517.12
|
| Rate for Payer: Healthscope Commercial |
$597.92
|
| Rate for Payer: Mclaren Medicaid |
$218.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.36
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,161.00
|
| Rate for Payer: Nomi Health Commercial |
$387.84
|
| Rate for Payer: PACE SWMI |
$323.20
|
| Rate for Payer: PHP Medicare Advantage |
$323.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$517.00
|
| Rate for Payer: Priority Health Medicare |
$323.20
|
| Rate for Payer: Priority Health Narrow Network |
$517.00
|
| Rate for Payer: Priority Health SBD |
$517.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.20
|
| Rate for Payer: UHC Medicare Advantage |
$323.20
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
IP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$759.78 |
| Max. Negotiated Rate |
$1,085.40 |
| Rate for Payer: Aetna Commercial |
$1,025.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.90
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$1,037.16
|
| Rate for Payer: Cofinity Commercial |
$844.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$844.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Healthscope Commercial |
$1,085.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,025.10
|
| Rate for Payer: PHP Commercial |
$1,025.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health SBD |
$759.78
|
|
