|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 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/>
|
Professional
|
Both
|
$1,399.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$137.89 |
| Max. Negotiated Rate |
$131,112.00 |
| Rate for Payer: Aetna Commercial |
$952.49
|
| Rate for Payer: Aetna Medicare |
$739.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$952.49
|
| Rate for Payer: BCBS Complete |
$499.86
|
| Rate for Payer: BCBS MAPPO |
$710.81
|
| Rate for Payer: BCBS Trust/PPO |
$137.89
|
| Rate for Payer: BCN Commercial |
$1,079.00
|
| Rate for Payer: BCN Medicare Advantage |
$710.81
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cofinity Commercial |
$952.49
|
| Rate for Payer: Cofinity Commercial |
$1,023.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.81
|
| Rate for Payer: Healthscope Commercial |
$1,137.30
|
| Rate for Payer: Healthscope Commercial |
$1,315.00
|
| Rate for Payer: Mclaren Medicaid |
$476.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$746.35
|
| Rate for Payer: Meridian Medicaid |
$499.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131,112.00
|
| Rate for Payer: Nomi Health Commercial |
$852.97
|
| Rate for Payer: PACE SWMI |
$710.81
|
| Rate for Payer: PHP Medicare Advantage |
$710.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.63
|
| Rate for Payer: Priority Health Medicare |
$710.81
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.63
|
| Rate for Payer: Priority Health SBD |
$1,127.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$710.81
|
| Rate for Payer: UHC Medicare Advantage |
$710.81
|
| Rate for Payer: UHCCP Medicaid |
$476.06
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$235.58 |
| Max. Negotiated Rate |
$64,060.00 |
| Rate for Payer: Aetna Commercial |
$468.28
|
| Rate for Payer: Aetna Medicare |
$363.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.22
|
| Rate for Payer: BCBS Complete |
$247.36
|
| Rate for Payer: BCBS MAPPO |
$349.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.14
|
| Rate for Payer: BCN Commercial |
$728.62
|
| Rate for Payer: BCN Medicare Advantage |
$349.46
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$503.22
|
| Rate for Payer: Cofinity Commercial |
$468.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.46
|
| Rate for Payer: Healthscope Commercial |
$646.50
|
| Rate for Payer: Healthscope Commercial |
$559.14
|
| Rate for Payer: Mclaren Medicaid |
$235.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.93
|
| Rate for Payer: Meridian Medicaid |
$247.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64,060.00
|
| Rate for Payer: Nomi Health Commercial |
$419.35
|
| Rate for Payer: PACE SWMI |
$349.46
|
| Rate for Payer: PHP Medicare Advantage |
$349.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.26
|
| Rate for Payer: Priority Health Medicare |
$349.46
|
| Rate for Payer: Priority Health Narrow Network |
$560.26
|
| Rate for Payer: Priority Health SBD |
$560.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$686.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.46
|
| Rate for Payer: UHC Exchange |
$686.94
|
| Rate for Payer: UHC Medicare Advantage |
$349.46
|
| Rate for Payer: UHCCP Medicaid |
$235.58
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,587.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$999.81 |
| Max. Negotiated Rate |
$1,428.30 |
| Rate for Payer: Aetna Commercial |
$1,348.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.55
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,110.90
|
| Rate for Payer: Cofinity Commercial |
$1,364.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,110.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.60
|
| Rate for Payer: Healthscope Commercial |
$1,428.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.95
|
| Rate for Payer: PHP Commercial |
$1,348.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health SBD |
$999.81
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$453.05 |
| Max. Negotiated Rate |
$124,114.00 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$701.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.88
|
| Rate for Payer: BCBS Complete |
$475.70
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Healthscope Commercial |
$1,079.87
|
| Rate for Payer: Healthscope Commercial |
$1,248.60
|
| Rate for Payer: Mclaren Medicaid |
$453.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Meridian Medicaid |
$475.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124,114.00
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.70
|
| Rate for Payer: Priority Health Medicare |
$674.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.70
|
| Rate for Payer: Priority Health SBD |
$1,073.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.92
|
| Rate for Payer: UHC Medicare Advantage |
$674.92
|
| Rate for Payer: UHCCP Medicaid |
$453.05
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$453.05 |
| Max. Negotiated Rate |
$124,114.00 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$701.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$904.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$971.88
|
| Rate for Payer: BCBS Complete |
$475.70
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Healthscope Commercial |
$1,079.87
|
| Rate for Payer: Healthscope Commercial |
$1,248.60
|
| Rate for Payer: Mclaren Medicaid |
$453.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Meridian Medicaid |
$475.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124,114.00
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.70
|
| Rate for Payer: Priority Health Medicare |
$674.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.70
|
| Rate for Payer: Priority Health SBD |
$1,073.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.92
|
| Rate for Payer: UHC Medicare Advantage |
$674.92
|
| Rate for Payer: UHCCP Medicaid |
$453.05
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,587.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$746.25 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,348.95
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.55
|
| 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 |
$1,693.29
|
| Rate for Payer: BCN Commercial |
$1,693.29
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,364.82
|
| Rate for Payer: Cofinity Commercial |
$1,110.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,110.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,428.30
|
| 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 |
$1,348.95
|
| 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 |
$1,348.95
|
| 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 |
$1,031.55
|
| 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 |
$999.81
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.25
|
| 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 THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$490.33 |
| Max. Negotiated Rate |
$134,149.00 |
| Rate for Payer: Aetna Commercial |
$980.08
|
| Rate for Payer: Aetna Medicare |
$760.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,053.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.08
|
| Rate for Payer: BCBS Complete |
$514.85
|
| Rate for Payer: BCBS MAPPO |
$731.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.52
|
| Rate for Payer: BCN Commercial |
$1,104.90
|
| Rate for Payer: BCN Medicare Advantage |
$731.40
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$980.08
|
| Rate for Payer: Cofinity Commercial |
$1,053.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.40
|
| Rate for Payer: Healthscope Commercial |
$1,170.24
|
| Rate for Payer: Healthscope Commercial |
$1,353.09
|
| Rate for Payer: Mclaren Medicaid |
$490.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.97
|
| Rate for Payer: Meridian Medicaid |
$514.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134,149.00
|
| Rate for Payer: Nomi Health Commercial |
$877.68
|
| Rate for Payer: PACE SWMI |
$731.40
|
| Rate for Payer: PHP Medicare Advantage |
$731.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,163.77
|
| Rate for Payer: Priority Health Medicare |
$731.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,163.77
|
| Rate for Payer: Priority Health SBD |
$1,163.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.40
|
| Rate for Payer: UHC Medicare Advantage |
$731.40
|
| Rate for Payer: UHCCP Medicaid |
$490.33
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,748.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$111,049.00 |
| Rate for Payer: Aetna Commercial |
$808.73
|
| Rate for Payer: Aetna Medicare |
$627.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$869.08
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS MAPPO |
$603.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.96
|
| Rate for Payer: BCN Commercial |
$917.25
|
| Rate for Payer: BCN Medicare Advantage |
$603.53
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cofinity Commercial |
$869.08
|
| Rate for Payer: Cofinity Commercial |
$808.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.53
|
| Rate for Payer: Healthscope Commercial |
$965.65
|
| Rate for Payer: Healthscope Commercial |
$1,116.53
|
| Rate for Payer: Mclaren Medicaid |
$405.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.71
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111,049.00
|
| Rate for Payer: Nomi Health Commercial |
$724.24
|
| Rate for Payer: PACE SWMI |
$603.53
|
| Rate for Payer: PHP Medicare Advantage |
$603.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$963.79
|
| Rate for Payer: Priority Health Medicare |
$603.53
|
| Rate for Payer: Priority Health Narrow Network |
$963.79
|
| Rate for Payer: Priority Health SBD |
$963.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$526.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.53
|
| Rate for Payer: UHC Exchange |
$526.61
|
| Rate for Payer: UHC Medicare Advantage |
$603.53
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,557.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$980.91 |
| Max. Negotiated Rate |
$1,401.30 |
| Rate for Payer: Aetna Commercial |
$1,323.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.05
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,089.90
|
| Rate for Payer: Cofinity Commercial |
$1,339.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,089.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Healthscope Commercial |
$1,401.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,323.45
|
| Rate for Payer: PHP Commercial |
$1,323.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health SBD |
$980.91
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,557.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,323.45
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,012.05
|
| 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 |
$1,370.81
|
| Rate for Payer: BCN Commercial |
$1,370.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,339.02
|
| Rate for Payer: Cofinity Commercial |
$1,089.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,089.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,401.30
|
| 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 |
$1,323.45
|
| 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 |
$1,323.45
|
| 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 |
$1,012.05
|
| 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 |
$980.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.70
|
| 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 UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$72,176.00 |
| Rate for Payer: Aetna Commercial |
$527.45
|
| Rate for Payer: Aetna Medicare |
$409.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.81
|
| Rate for Payer: BCBS Complete |
$278.00
|
| Rate for Payer: BCBS MAPPO |
$393.62
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$596.19
|
| Rate for Payer: BCN Medicare Advantage |
$393.62
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$566.81
|
| Rate for Payer: Cofinity Commercial |
$527.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.62
|
| Rate for Payer: Healthscope Commercial |
$629.79
|
| Rate for Payer: Healthscope Commercial |
$728.20
|
| Rate for Payer: Mclaren Medicaid |
$264.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.30
|
| Rate for Payer: Meridian Medicaid |
$278.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,176.00
|
| Rate for Payer: Nomi Health Commercial |
$472.34
|
| Rate for Payer: PACE SWMI |
$393.62
|
| Rate for Payer: PHP Medicare Advantage |
$393.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.91
|
| Rate for Payer: Priority Health Medicare |
$393.62
|
| Rate for Payer: Priority Health Narrow Network |
$626.91
|
| Rate for Payer: Priority Health SBD |
$626.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.62
|
| Rate for Payer: UHC Medicare Advantage |
$393.62
|
| Rate for Payer: UHCCP Medicaid |
$264.76
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$72,176.00 |
| Rate for Payer: Aetna Commercial |
$527.45
|
| Rate for Payer: Aetna Medicare |
$409.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$527.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.81
|
| Rate for Payer: BCBS Complete |
$278.00
|
| Rate for Payer: BCBS MAPPO |
$393.62
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$596.19
|
| Rate for Payer: BCN Medicare Advantage |
$393.62
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$566.81
|
| Rate for Payer: Cofinity Commercial |
$527.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.62
|
| Rate for Payer: Healthscope Commercial |
$629.79
|
| Rate for Payer: Healthscope Commercial |
$728.20
|
| Rate for Payer: Mclaren Medicaid |
$264.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.30
|
| Rate for Payer: Meridian Medicaid |
$278.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,176.00
|
| Rate for Payer: Nomi Health Commercial |
$472.34
|
| Rate for Payer: PACE SWMI |
$393.62
|
| Rate for Payer: PHP Medicare Advantage |
$393.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.91
|
| Rate for Payer: Priority Health Medicare |
$393.62
|
| Rate for Payer: Priority Health Narrow Network |
$626.91
|
| Rate for Payer: Priority Health SBD |
$626.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.62
|
| Rate for Payer: UHC Medicare Advantage |
$393.62
|
| Rate for Payer: UHCCP Medicaid |
$264.76
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$351.86 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.05
|
| 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 |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Cofinity Commercial |
$907.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| 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 |
$1,102.45
|
| 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 |
$1,102.45
|
| 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 |
$843.05
|
| 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 |
$817.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.86
|
| 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 TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$58,543.00 |
| Rate for Payer: Aetna Commercial |
$427.14
|
| Rate for Payer: Aetna Medicare |
$331.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.01
|
| Rate for Payer: BCBS Complete |
$227.01
|
| Rate for Payer: BCBS MAPPO |
$318.76
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$318.76
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$459.01
|
| Rate for Payer: Cofinity Commercial |
$427.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.76
|
| Rate for Payer: Healthscope Commercial |
$589.71
|
| Rate for Payer: Healthscope Commercial |
$510.02
|
| Rate for Payer: Mclaren Medicaid |
$216.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.70
|
| Rate for Payer: Meridian Medicaid |
$227.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,543.00
|
| Rate for Payer: Nomi Health Commercial |
$382.51
|
| Rate for Payer: PACE SWMI |
$318.76
|
| Rate for Payer: PHP Medicare Advantage |
$318.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.41
|
| Rate for Payer: Priority Health Medicare |
$318.76
|
| Rate for Payer: Priority Health Narrow Network |
$511.41
|
| Rate for Payer: Priority Health SBD |
$511.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.76
|
| Rate for Payer: UHC Exchange |
$478.65
|
| Rate for Payer: UHC Medicare Advantage |
$318.76
|
| Rate for Payer: UHCCP Medicaid |
$216.20
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$817.11 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$843.05
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Cofinity Commercial |
$907.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$907.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.45
|
| Rate for Payer: PHP Commercial |
$1,102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health SBD |
$817.11
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$58,543.00 |
| Rate for Payer: Aetna Commercial |
$427.14
|
| Rate for Payer: Aetna Medicare |
$331.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.01
|
| Rate for Payer: BCBS Complete |
$227.01
|
| Rate for Payer: BCBS MAPPO |
$318.76
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$318.76
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$459.01
|
| Rate for Payer: Cofinity Commercial |
$427.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.76
|
| Rate for Payer: Healthscope Commercial |
$589.71
|
| Rate for Payer: Healthscope Commercial |
$510.02
|
| Rate for Payer: Mclaren Medicaid |
$216.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.70
|
| Rate for Payer: Meridian Medicaid |
$227.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58,543.00
|
| Rate for Payer: Nomi Health Commercial |
$382.51
|
| Rate for Payer: PACE SWMI |
$318.76
|
| Rate for Payer: PHP Medicare Advantage |
$318.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.41
|
| Rate for Payer: Priority Health Medicare |
$318.76
|
| Rate for Payer: Priority Health Narrow Network |
$511.41
|
| Rate for Payer: Priority Health SBD |
$511.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.76
|
| Rate for Payer: UHC Exchange |
$478.65
|
| Rate for Payer: UHC Medicare Advantage |
$318.76
|
| Rate for Payer: UHCCP Medicaid |
$216.20
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$123,397.00 |
| Rate for Payer: Aetna Commercial |
$900.84
|
| Rate for Payer: Aetna Medicare |
$699.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.07
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS MAPPO |
$672.27
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$672.27
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$968.07
|
| Rate for Payer: Cofinity Commercial |
$900.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.27
|
| Rate for Payer: Healthscope Commercial |
$1,075.63
|
| Rate for Payer: Healthscope Commercial |
$1,243.70
|
| Rate for Payer: Mclaren Medicaid |
$451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.88
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123,397.00
|
| Rate for Payer: Nomi Health Commercial |
$806.72
|
| Rate for Payer: PACE SWMI |
$672.27
|
| Rate for Payer: PHP Medicare Advantage |
$672.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.59
|
| Rate for Payer: Priority Health Medicare |
$672.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.59
|
| Rate for Payer: Priority Health SBD |
$1,067.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.27
|
| Rate for Payer: UHC Medicare Advantage |
$672.27
|
| Rate for Payer: UHCCP Medicaid |
$451.13
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,693.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$742.03 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$1,439.05
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.65
|
| Rate for Payer: BCN Commercial |
$1,075.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$1,455.98
|
| Rate for Payer: Cofinity Commercial |
$1,185.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,185.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,523.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.05
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,439.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$1,066.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.03
|
| 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 UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,693.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,066.59 |
| Max. Negotiated Rate |
$1,523.70 |
| Rate for Payer: Aetna Commercial |
$1,439.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.45
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$1,185.10
|
| Rate for Payer: Cofinity Commercial |
$1,455.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,185.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.40
|
| Rate for Payer: Healthscope Commercial |
$1,523.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.05
|
| Rate for Payer: PHP Commercial |
$1,439.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health SBD |
$1,066.59
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$123,397.00 |
| Rate for Payer: Aetna Commercial |
$900.84
|
| Rate for Payer: Aetna Medicare |
$699.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$900.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$968.07
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS MAPPO |
$672.27
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$672.27
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$968.07
|
| Rate for Payer: Cofinity Commercial |
$900.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$672.27
|
| Rate for Payer: Healthscope Commercial |
$1,075.63
|
| Rate for Payer: Healthscope Commercial |
$1,243.70
|
| Rate for Payer: Mclaren Medicaid |
$451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$705.88
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123,397.00
|
| Rate for Payer: Nomi Health Commercial |
$806.72
|
| Rate for Payer: PACE SWMI |
$672.27
|
| Rate for Payer: PHP Medicare Advantage |
$672.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.59
|
| Rate for Payer: Priority Health Medicare |
$672.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.59
|
| Rate for Payer: Priority Health SBD |
$1,067.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$672.27
|
| Rate for Payer: UHC Medicare Advantage |
$672.27
|
| Rate for Payer: UHCCP Medicaid |
$451.13
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$1,155.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$727.65 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.75
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$808.50
|
| Rate for Payer: Cofinity Commercial |
$993.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$808.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.00
|
| Rate for Payer: Healthscope Commercial |
$1,039.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$981.75
|
| Rate for Payer: PHP Commercial |
$981.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health SBD |
$727.65
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$1,155.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$584.39 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$981.75
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$993.30
|
| Rate for Payer: Cofinity Commercial |
$808.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$808.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,039.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$981.75
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$981.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$727.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$584.39
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$97,315.00 |
| Rate for Payer: Aetna Commercial |
$709.45
|
| Rate for Payer: Aetna Medicare |
$550.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.39
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$529.44
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$806.80
|
| Rate for Payer: BCN Medicare Advantage |
$529.44
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$762.39
|
| Rate for Payer: Cofinity Commercial |
$709.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.44
|
| Rate for Payer: Healthscope Commercial |
$979.46
|
| Rate for Payer: Healthscope Commercial |
$847.10
|
| Rate for Payer: Mclaren Medicaid |
$357.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.91
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97,315.00
|
| Rate for Payer: Nomi Health Commercial |
$635.33
|
| Rate for Payer: PACE SWMI |
$529.44
|
| Rate for Payer: PHP Medicare Advantage |
$529.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.74
|
| Rate for Payer: Priority Health Medicare |
$529.44
|
| Rate for Payer: Priority Health Narrow Network |
$846.74
|
| Rate for Payer: Priority Health SBD |
$846.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.44
|
| Rate for Payer: UHC Exchange |
$556.26
|
| Rate for Payer: UHC Medicare Advantage |
$529.44
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
24076
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$97,315.00 |
| Rate for Payer: Aetna Commercial |
$709.45
|
| Rate for Payer: Aetna Medicare |
$550.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$762.39
|
| Rate for Payer: BCBS Complete |
$375.73
|
| Rate for Payer: BCBS MAPPO |
$529.44
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$806.80
|
| Rate for Payer: BCN Medicare Advantage |
$529.44
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$762.39
|
| Rate for Payer: Cofinity Commercial |
$709.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.44
|
| Rate for Payer: Healthscope Commercial |
$979.46
|
| Rate for Payer: Healthscope Commercial |
$847.10
|
| Rate for Payer: Mclaren Medicaid |
$357.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.91
|
| Rate for Payer: Meridian Medicaid |
$375.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97,315.00
|
| Rate for Payer: Nomi Health Commercial |
$635.33
|
| Rate for Payer: PACE SWMI |
$529.44
|
| Rate for Payer: PHP Medicare Advantage |
$529.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$846.74
|
| Rate for Payer: Priority Health Medicare |
$529.44
|
| Rate for Payer: Priority Health Narrow Network |
$846.74
|
| Rate for Payer: Priority Health SBD |
$846.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.44
|
| Rate for Payer: UHC Exchange |
$556.26
|
| Rate for Payer: UHC Medicare Advantage |
$529.44
|
| Rate for Payer: UHCCP Medicaid |
$357.84
|
|
