|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$79,380.00 |
| Rate for Payer: Aetna Commercial |
$577.78
|
| Rate for Payer: Aetna Medicare |
$448.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.90
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$431.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$431.18
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$620.90
|
| Rate for Payer: Cofinity Commercial |
$577.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.18
|
| Rate for Payer: Healthscope Commercial |
$689.89
|
| Rate for Payer: Healthscope Commercial |
$797.68
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.74
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,380.00
|
| Rate for Payer: Nomi Health Commercial |
$517.42
|
| Rate for Payer: PACE SWMI |
$431.18
|
| Rate for Payer: PHP Medicare Advantage |
$431.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.58
|
| Rate for Payer: Priority Health Medicare |
$431.18
|
| Rate for Payer: Priority Health Narrow Network |
$693.58
|
| Rate for Payer: Priority Health SBD |
$693.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.18
|
| Rate for Payer: UHC Medicare Advantage |
$431.18
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
OP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$478.12 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,025.10
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.90
|
| 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 |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$844.20
|
| Rate for Payer: Cofinity Commercial |
$1,037.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$844.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,085.40
|
| 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 |
$1,025.10
|
| 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 |
$1,025.10
|
| 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 |
$783.90
|
| 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 |
$759.78
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.12
|
| 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 FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$79,380.00 |
| Rate for Payer: Aetna Commercial |
$577.78
|
| Rate for Payer: Aetna Medicare |
$448.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$577.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.90
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$431.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$431.18
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$620.90
|
| Rate for Payer: Cofinity Commercial |
$577.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.18
|
| Rate for Payer: Healthscope Commercial |
$689.89
|
| Rate for Payer: Healthscope Commercial |
$797.68
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.74
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79,380.00
|
| Rate for Payer: Nomi Health Commercial |
$517.42
|
| Rate for Payer: PACE SWMI |
$431.18
|
| Rate for Payer: PHP Medicare Advantage |
$431.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.58
|
| Rate for Payer: Priority Health Medicare |
$431.18
|
| Rate for Payer: Priority Health Narrow Network |
$693.58
|
| Rate for Payer: Priority Health SBD |
$693.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.18
|
| Rate for Payer: UHC Medicare Advantage |
$431.18
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$61,117.00 |
| Rate for Payer: Aetna Commercial |
$447.57
|
| Rate for Payer: Aetna Medicare |
$347.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.97
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCBS MAPPO |
$334.01
|
| Rate for Payer: BCBS Trust/PPO |
$699.47
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$334.01
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$480.97
|
| Rate for Payer: Cofinity Commercial |
$447.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.01
|
| Rate for Payer: Healthscope Commercial |
$617.92
|
| Rate for Payer: Healthscope Commercial |
$534.42
|
| Rate for Payer: Mclaren Medicaid |
$226.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.71
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,117.00
|
| Rate for Payer: Nomi Health Commercial |
$400.81
|
| Rate for Payer: PACE SWMI |
$334.01
|
| Rate for Payer: PHP Medicare Advantage |
$334.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.31
|
| Rate for Payer: Priority Health Medicare |
$334.01
|
| Rate for Payer: Priority Health Narrow Network |
$534.31
|
| Rate for Payer: Priority Health SBD |
$534.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$334.01
|
| Rate for Payer: UHC Exchange |
$563.28
|
| Rate for Payer: UHC Medicare Advantage |
$334.01
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$740.25 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Aetna Commercial |
$998.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.75
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,010.50
|
| Rate for Payer: Cofinity Commercial |
$822.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Healthscope Commercial |
$1,057.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: PHP Commercial |
$998.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health SBD |
$740.25
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.80 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$998.75
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.20
|
| Rate for Payer: BCN Commercial |
$1,155.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,010.50
|
| Rate for Payer: Cofinity Commercial |
$822.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$822.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,057.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$998.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$740.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.80
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$3,362.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$207.68 |
| Max. Negotiated Rate |
$56,012.00 |
| Rate for Payer: Aetna Commercial |
$409.36
|
| Rate for Payer: Aetna Medicare |
$317.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.91
|
| Rate for Payer: BCBS Complete |
$218.06
|
| Rate for Payer: BCBS MAPPO |
$305.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.69
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: BCN Medicare Advantage |
$305.49
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$439.91
|
| Rate for Payer: Cofinity Commercial |
$409.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.49
|
| Rate for Payer: Healthscope Commercial |
$565.16
|
| Rate for Payer: Healthscope Commercial |
$488.78
|
| Rate for Payer: Mclaren Medicaid |
$207.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.76
|
| Rate for Payer: Meridian Medicaid |
$218.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,012.00
|
| Rate for Payer: Nomi Health Commercial |
$366.59
|
| Rate for Payer: PACE SWMI |
$305.49
|
| Rate for Payer: PHP Medicare Advantage |
$305.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.04
|
| Rate for Payer: Priority Health Medicare |
$305.49
|
| Rate for Payer: Priority Health Narrow Network |
$491.04
|
| Rate for Payer: Priority Health SBD |
$491.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.49
|
| Rate for Payer: UHC Exchange |
$440.19
|
| Rate for Payer: UHC Medicare Advantage |
$305.49
|
| Rate for Payer: UHCCP Medicaid |
$207.68
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25075
|
| Hospital Charge Code |
25075
|
| Min. Negotiated Rate |
$207.68 |
| Max. Negotiated Rate |
$56,012.00 |
| Rate for Payer: Aetna Commercial |
$409.36
|
| Rate for Payer: Aetna Medicare |
$317.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.91
|
| Rate for Payer: BCBS Complete |
$218.06
|
| Rate for Payer: BCBS MAPPO |
$305.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.69
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: BCN Medicare Advantage |
$305.49
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$439.91
|
| Rate for Payer: Cofinity Commercial |
$409.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.49
|
| Rate for Payer: Healthscope Commercial |
$565.16
|
| Rate for Payer: Healthscope Commercial |
$488.78
|
| Rate for Payer: Mclaren Medicaid |
$207.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.76
|
| Rate for Payer: Meridian Medicaid |
$218.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,012.00
|
| Rate for Payer: Nomi Health Commercial |
$366.59
|
| Rate for Payer: PACE SWMI |
$305.49
|
| Rate for Payer: PHP Medicare Advantage |
$305.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.04
|
| Rate for Payer: Priority Health Medicare |
$305.49
|
| Rate for Payer: Priority Health Narrow Network |
$491.04
|
| Rate for Payer: Priority Health SBD |
$491.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.49
|
| Rate for Payer: UHC Exchange |
$440.19
|
| Rate for Payer: UHC Medicare Advantage |
$305.49
|
| Rate for Payer: UHCCP Medicaid |
$207.68
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 27634
|
| Min. Negotiated Rate |
$434.73 |
| Max. Negotiated Rate |
$120,276.00 |
| Rate for Payer: Aetna Commercial |
$867.14
|
| Rate for Payer: Aetna Medicare |
$673.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.85
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCBS MAPPO |
$647.12
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$992.02
|
| Rate for Payer: BCN Medicare Advantage |
$647.12
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cofinity Commercial |
$931.85
|
| Rate for Payer: Cofinity Commercial |
$867.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.12
|
| Rate for Payer: Healthscope Commercial |
$1,035.39
|
| Rate for Payer: Healthscope Commercial |
$1,197.17
|
| Rate for Payer: Mclaren Medicaid |
$434.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$679.48
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120,276.00
|
| Rate for Payer: Nomi Health Commercial |
$776.54
|
| Rate for Payer: PACE SWMI |
$647.12
|
| Rate for Payer: PHP Medicare Advantage |
$647.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,035.03
|
| Rate for Payer: Priority Health Medicare |
$647.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,035.03
|
| Rate for Payer: Priority Health SBD |
$1,035.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.12
|
| Rate for Payer: UHC Medicare Advantage |
$647.12
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$303.53 |
| Max. Negotiated Rate |
$83,038.00 |
| Rate for Payer: Aetna Commercial |
$602.52
|
| Rate for Payer: Aetna Medicare |
$467.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$602.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.48
|
| Rate for Payer: BCBS Complete |
$318.71
|
| Rate for Payer: BCBS MAPPO |
$449.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,538.94
|
| Rate for Payer: BCN Commercial |
$687.08
|
| Rate for Payer: BCN Medicare Advantage |
$449.64
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cofinity Commercial |
$647.48
|
| Rate for Payer: Cofinity Commercial |
$602.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.64
|
| Rate for Payer: Healthscope Commercial |
$831.83
|
| Rate for Payer: Healthscope Commercial |
$719.42
|
| Rate for Payer: Mclaren Medicaid |
$303.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.12
|
| Rate for Payer: Meridian Medicaid |
$318.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83,038.00
|
| Rate for Payer: Nomi Health Commercial |
$539.57
|
| Rate for Payer: PACE SWMI |
$449.64
|
| Rate for Payer: PHP Medicare Advantage |
$449.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$810.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.16
|
| Rate for Payer: Priority Health Medicare |
$449.64
|
| Rate for Payer: Priority Health Narrow Network |
$727.16
|
| Rate for Payer: Priority Health SBD |
$727.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$951.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.64
|
| Rate for Payer: UHC Exchange |
$951.54
|
| Rate for Payer: UHC Medicare Advantage |
$449.64
|
| Rate for Payer: UHCCP Medicaid |
$303.53
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$54,072.00 |
| Rate for Payer: Aetna Commercial |
$394.40
|
| Rate for Payer: Aetna Medicare |
$306.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.84
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS MAPPO |
$294.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$294.33
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$423.84
|
| Rate for Payer: Cofinity Commercial |
$394.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.33
|
| Rate for Payer: Healthscope Commercial |
$544.51
|
| Rate for Payer: Healthscope Commercial |
$470.93
|
| Rate for Payer: Mclaren Medicaid |
$199.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.05
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,072.00
|
| Rate for Payer: Nomi Health Commercial |
$353.20
|
| Rate for Payer: PACE SWMI |
$294.33
|
| Rate for Payer: PHP Medicare Advantage |
$294.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.26
|
| Rate for Payer: Priority Health Medicare |
$294.33
|
| Rate for Payer: Priority Health Narrow Network |
$474.26
|
| Rate for Payer: Priority Health SBD |
$474.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.33
|
| Rate for Payer: UHC Exchange |
$721.18
|
| Rate for Payer: UHC Medicare Advantage |
$294.33
|
| Rate for Payer: UHCCP Medicaid |
$199.79
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$54,072.00 |
| Rate for Payer: Aetna Commercial |
$394.40
|
| Rate for Payer: Aetna Medicare |
$306.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.84
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS MAPPO |
$294.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$294.33
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$423.84
|
| Rate for Payer: Cofinity Commercial |
$394.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.33
|
| Rate for Payer: Healthscope Commercial |
$544.51
|
| Rate for Payer: Healthscope Commercial |
$470.93
|
| Rate for Payer: Mclaren Medicaid |
$199.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.05
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,072.00
|
| Rate for Payer: Nomi Health Commercial |
$353.20
|
| Rate for Payer: PACE SWMI |
$294.33
|
| Rate for Payer: PHP Medicare Advantage |
$294.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.26
|
| Rate for Payer: Priority Health Medicare |
$294.33
|
| Rate for Payer: Priority Health Narrow Network |
$474.26
|
| Rate for Payer: Priority Health SBD |
$474.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$721.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.33
|
| Rate for Payer: UHC Exchange |
$721.18
|
| Rate for Payer: UHC Medicare Advantage |
$294.33
|
| Rate for Payer: UHCCP Medicaid |
$199.79
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
IP
|
$1,084.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$682.92 |
| Max. Negotiated Rate |
$975.60 |
| Rate for Payer: Aetna Commercial |
$921.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.60
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$758.80
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$758.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Healthscope Commercial |
$975.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: PHP Commercial |
$921.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health SBD |
$682.92
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$325.69 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$921.40
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$704.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$768.35
|
| Rate for Payer: BCN Commercial |
$768.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$932.24
|
| Rate for Payer: Cofinity Commercial |
$758.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$758.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$975.60
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$921.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$682.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.69
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$54,290.00 |
| Rate for Payer: Aetna Commercial |
$396.44
|
| Rate for Payer: Aetna Medicare |
$307.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.02
|
| Rate for Payer: BCBS Complete |
$210.68
|
| Rate for Payer: BCBS MAPPO |
$295.85
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$295.85
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$426.02
|
| Rate for Payer: Cofinity Commercial |
$396.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.85
|
| Rate for Payer: Healthscope Commercial |
$547.32
|
| Rate for Payer: Healthscope Commercial |
$473.36
|
| Rate for Payer: Mclaren Medicaid |
$200.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.64
|
| Rate for Payer: Meridian Medicaid |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,290.00
|
| Rate for Payer: Nomi Health Commercial |
$355.02
|
| Rate for Payer: PACE SWMI |
$295.85
|
| Rate for Payer: PHP Medicare Advantage |
$295.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.28
|
| Rate for Payer: Priority Health Medicare |
$295.85
|
| Rate for Payer: Priority Health Narrow Network |
$475.28
|
| Rate for Payer: Priority Health SBD |
$475.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.85
|
| Rate for Payer: UHC Exchange |
$429.29
|
| Rate for Payer: UHC Medicare Advantage |
$295.85
|
| Rate for Payer: UHCCP Medicaid |
$200.65
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$806.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$507.78 |
| Max. Negotiated Rate |
$725.40 |
| Rate for Payer: Aetna Commercial |
$685.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.90
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$564.20
|
| Rate for Payer: Cofinity Commercial |
$693.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$564.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.80
|
| Rate for Payer: Healthscope Commercial |
$725.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: PHP Commercial |
$685.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health SBD |
$507.78
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$54,290.00 |
| Rate for Payer: Aetna Commercial |
$396.44
|
| Rate for Payer: Aetna Medicare |
$307.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.02
|
| Rate for Payer: BCBS Complete |
$210.68
|
| Rate for Payer: BCBS MAPPO |
$295.85
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$295.85
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$426.02
|
| Rate for Payer: Cofinity Commercial |
$396.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.85
|
| Rate for Payer: Healthscope Commercial |
$547.32
|
| Rate for Payer: Healthscope Commercial |
$473.36
|
| Rate for Payer: Mclaren Medicaid |
$200.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.64
|
| Rate for Payer: Meridian Medicaid |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,290.00
|
| Rate for Payer: Nomi Health Commercial |
$355.02
|
| Rate for Payer: PACE SWMI |
$295.85
|
| Rate for Payer: PHP Medicare Advantage |
$295.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.28
|
| Rate for Payer: Priority Health Medicare |
$295.85
|
| Rate for Payer: Priority Health Narrow Network |
$475.28
|
| Rate for Payer: Priority Health SBD |
$475.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.85
|
| Rate for Payer: UHC Exchange |
$429.29
|
| Rate for Payer: UHC Medicare Advantage |
$295.85
|
| Rate for Payer: UHCCP Medicaid |
$200.65
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$806.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$326.81 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$685.10
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$523.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.42
|
| Rate for Payer: BCN Commercial |
$1,452.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$693.16
|
| Rate for Payer: Cofinity Commercial |
$564.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$564.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$725.40
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$685.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$507.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.81
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$240.88 |
| Max. Negotiated Rate |
$130,324.00 |
| Rate for Payer: Aetna Commercial |
$948.14
|
| Rate for Payer: Aetna Medicare |
$735.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.14
|
| Rate for Payer: BCBS Complete |
$497.40
|
| Rate for Payer: BCBS MAPPO |
$707.57
|
| Rate for Payer: BCBS Trust/PPO |
$240.88
|
| Rate for Payer: BCN Commercial |
$1,072.16
|
| Rate for Payer: BCN Medicare Advantage |
$707.57
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$948.14
|
| Rate for Payer: Cofinity Commercial |
$1,018.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.57
|
| Rate for Payer: Healthscope Commercial |
$1,132.11
|
| Rate for Payer: Healthscope Commercial |
$1,309.00
|
| Rate for Payer: Mclaren Medicaid |
$473.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.95
|
| Rate for Payer: Meridian Medicaid |
$497.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130,324.00
|
| Rate for Payer: Nomi Health Commercial |
$849.08
|
| Rate for Payer: PACE SWMI |
$707.57
|
| Rate for Payer: PHP Medicare Advantage |
$707.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,124.58
|
| Rate for Payer: Priority Health Medicare |
$707.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.58
|
| Rate for Payer: Priority Health SBD |
$1,124.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.57
|
| Rate for Payer: UHC Medicare Advantage |
$707.57
|
| Rate for Payer: UHCCP Medicaid |
$473.71
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
IP
|
$2,144.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,350.72 |
| Max. Negotiated Rate |
$1,929.60 |
| Rate for Payer: Aetna Commercial |
$1,822.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.60
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$1,500.80
|
| Rate for Payer: Cofinity Commercial |
$1,843.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,500.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,715.20
|
| Rate for Payer: Healthscope Commercial |
$1,929.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,822.40
|
| Rate for Payer: PHP Commercial |
$1,822.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health SBD |
$1,350.72
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$240.88 |
| Max. Negotiated Rate |
$130,324.00 |
| Rate for Payer: Aetna Commercial |
$948.14
|
| Rate for Payer: Aetna Medicare |
$735.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,018.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$948.14
|
| Rate for Payer: BCBS Complete |
$497.40
|
| Rate for Payer: BCBS MAPPO |
$707.57
|
| Rate for Payer: BCBS Trust/PPO |
$240.88
|
| Rate for Payer: BCN Commercial |
$1,072.16
|
| Rate for Payer: BCN Medicare Advantage |
$707.57
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$948.14
|
| Rate for Payer: Cofinity Commercial |
$1,018.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.57
|
| Rate for Payer: Healthscope Commercial |
$1,132.11
|
| Rate for Payer: Healthscope Commercial |
$1,309.00
|
| Rate for Payer: Mclaren Medicaid |
$473.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.95
|
| Rate for Payer: Meridian Medicaid |
$497.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130,324.00
|
| Rate for Payer: Nomi Health Commercial |
$849.08
|
| Rate for Payer: PACE SWMI |
$707.57
|
| Rate for Payer: PHP Medicare Advantage |
$707.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,124.58
|
| Rate for Payer: Priority Health Medicare |
$707.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.58
|
| Rate for Payer: Priority Health SBD |
$1,124.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.57
|
| Rate for Payer: UHC Medicare Advantage |
$707.57
|
| Rate for Payer: UHCCP Medicaid |
$473.71
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
OP
|
$2,144.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$783.40 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,822.40
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,393.60
|
| 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 |
$1,915.64
|
| Rate for Payer: BCN Commercial |
$1,915.64
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$1,843.84
|
| Rate for Payer: Cofinity Commercial |
$1,500.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,500.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,715.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,929.60
|
| 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 |
$1,822.40
|
| 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 |
$1,822.40
|
| 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 |
$1,393.60
|
| 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 |
$1,350.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.40
|
| 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 PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$109,033.00 |
| Rate for Payer: Aetna Commercial |
$797.45
|
| Rate for Payer: Aetna Medicare |
$618.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$856.96
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS MAPPO |
$595.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,154.02
|
| Rate for Payer: BCN Commercial |
$899.16
|
| Rate for Payer: BCN Medicare Advantage |
$595.11
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$856.96
|
| Rate for Payer: Cofinity Commercial |
$797.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.11
|
| Rate for Payer: Healthscope Commercial |
$952.18
|
| Rate for Payer: Healthscope Commercial |
$1,100.95
|
| Rate for Payer: Mclaren Medicaid |
$399.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.87
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109,033.00
|
| Rate for Payer: Nomi Health Commercial |
$714.13
|
| Rate for Payer: PACE SWMI |
$595.11
|
| Rate for Payer: PHP Medicare Advantage |
$595.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$944.96
|
| Rate for Payer: Priority Health Medicare |
$595.11
|
| Rate for Payer: Priority Health Narrow Network |
$944.96
|
| Rate for Payer: Priority Health SBD |
$944.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.11
|
| Rate for Payer: UHC Exchange |
$582.49
|
| Rate for Payer: UHC Medicare Advantage |
$595.11
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
IP
|
$1,269.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$799.47 |
| Max. Negotiated Rate |
$1,142.10 |
| Rate for Payer: Aetna Commercial |
$1,078.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.85
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$1,091.34
|
| Rate for Payer: Cofinity Commercial |
$888.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$888.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.20
|
| Rate for Payer: Healthscope Commercial |
$1,142.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,078.65
|
| Rate for Payer: PHP Commercial |
$1,078.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health SBD |
$799.47
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
OP
|
$1,269.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$656.58 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,078.65
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.85
|
| 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 |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$888.30
|
| Rate for Payer: Cofinity Commercial |
$1,091.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$888.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,142.10
|
| 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 |
$1,078.65
|
| 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 |
$1,078.65
|
| 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 |
$824.85
|
| 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 |
$799.47
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.58
|
| 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
|
|
