|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Facility
|
IP
|
$1,343.00
|
|
|
Service Code
|
CPT 45171
|
| Hospital Charge Code |
45171
|
| Min. Negotiated Rate |
$819.10 |
| Max. Negotiated Rate |
$1,208.70 |
| Rate for Payer: Aetna Commercial |
$1,141.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.87
|
| Rate for Payer: BCN Commercial |
$1,037.87
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.40
|
| Rate for Payer: Healthscope Commercial |
$1,208.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,007.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,141.55
|
| Rate for Payer: PHP Commercial |
$1,141.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,168.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$819.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.84
|
| Rate for Payer: UHC Core |
$1,121.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,007.25
|
|
|
PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA
|
Professional
|
Both
|
$1,343.00
|
|
|
Service Code
|
HCPCS 45171
|
| Min. Negotiated Rate |
$395.97 |
| Max. Negotiated Rate |
$2,751.91 |
| Rate for Payer: Aetna Commercial |
$810.45
|
| Rate for Payer: Aetna Medicare |
$629.00
|
| Rate for Payer: BCBS Complete |
$415.77
|
| Rate for Payer: BCBS MAPPO |
$604.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.91
|
| Rate for Payer: BCN Commercial |
$905.03
|
| Rate for Payer: BCN Medicare Advantage |
$604.81
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cash Price |
$1,074.40
|
| Rate for Payer: Cofinity Commercial |
$870.93
|
| Rate for Payer: Cofinity Commercial |
$810.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.81
|
| Rate for Payer: Mclaren Medicaid |
$395.97
|
| Rate for Payer: Meridian Medicaid |
$415.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$635.05
|
| Rate for Payer: PACE SWMI |
$604.81
|
| Rate for Payer: PHP Medicare Advantage |
$604.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$940.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.92
|
| Rate for Payer: Priority Health Medicare |
$604.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,088.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.81
|
| Rate for Payer: UHC Medicare Advantage |
$622.95
|
|
|
PR EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 45160
|
| Min. Negotiated Rate |
$658.17 |
| Max. Negotiated Rate |
$1,805.67 |
| Rate for Payer: Aetna Commercial |
$1,367.04
|
| Rate for Payer: Aetna Medicare |
$1,060.99
|
| Rate for Payer: BCBS Complete |
$691.08
|
| Rate for Payer: BCBS MAPPO |
$1,020.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.43
|
| Rate for Payer: BCN Commercial |
$1,500.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.18
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,469.06
|
| Rate for Payer: Cofinity Commercial |
$1,367.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.18
|
| Rate for Payer: Mclaren Medicaid |
$658.17
|
| Rate for Payer: Meridian Medicaid |
$691.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,071.19
|
| Rate for Payer: PACE SWMI |
$1,020.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,805.67
|
| Rate for Payer: Priority Health Medicare |
$1,020.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,805.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,020.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,020.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,050.79
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR
|
Professional
|
Both
|
$1,519.00
|
|
|
Service Code
|
HCPCS 15936
|
| Min. Negotiated Rate |
$575.31 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Aetna Commercial |
$1,191.13
|
| Rate for Payer: Aetna Medicare |
$924.46
|
| Rate for Payer: BCBS Complete |
$604.08
|
| Rate for Payer: BCBS MAPPO |
$888.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,625.00
|
| Rate for Payer: BCN Commercial |
$1,319.92
|
| Rate for Payer: BCN Medicare Advantage |
$888.90
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cash Price |
$1,215.20
|
| Rate for Payer: Cofinity Commercial |
$1,280.02
|
| Rate for Payer: Cofinity Commercial |
$1,191.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$888.90
|
| Rate for Payer: Mclaren Medicaid |
$575.31
|
| Rate for Payer: Meridian Medicaid |
$604.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$933.34
|
| Rate for Payer: PACE SWMI |
$888.90
|
| Rate for Payer: PHP Medicare Advantage |
$888.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$575.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,063.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,110.21
|
| Rate for Payer: Priority Health Medicare |
$888.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,110.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$888.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$888.90
|
| Rate for Payer: UHC Medicare Advantage |
$915.57
|
|
|
PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC
|
Professional
|
Both
|
$2,066.00
|
|
|
Service Code
|
HCPCS 15937
|
| Min. Negotiated Rate |
$663.50 |
| Max. Negotiated Rate |
$1,527.61 |
| Rate for Payer: Aetna Commercial |
$1,376.52
|
| Rate for Payer: Aetna Medicare |
$1,068.34
|
| Rate for Payer: BCBS Complete |
$696.68
|
| Rate for Payer: BCBS MAPPO |
$1,027.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,266.07
|
| Rate for Payer: BCN Commercial |
$1,527.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.25
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cash Price |
$1,652.80
|
| Rate for Payer: Cofinity Commercial |
$1,479.24
|
| Rate for Payer: Cofinity Commercial |
$1,376.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.25
|
| Rate for Payer: Mclaren Medicaid |
$663.50
|
| Rate for Payer: Meridian Medicaid |
$696.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,078.61
|
| Rate for Payer: PACE SWMI |
$1,027.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$663.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,284.90
|
| Rate for Payer: Priority Health Medicare |
$1,027.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,284.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,027.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,027.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,058.07
|
|
|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$223.44 |
| Max. Negotiated Rate |
$801.43 |
| Rate for Payer: Aetna Commercial |
$454.15
|
| Rate for Payer: Aetna Medicare |
$352.48
|
| Rate for Payer: BCBS Complete |
$234.61
|
| Rate for Payer: BCBS MAPPO |
$338.92
|
| Rate for Payer: BCBS Trust/PPO |
$229.28
|
| Rate for Payer: BCN Commercial |
$801.43
|
| Rate for Payer: BCN Medicare Advantage |
$338.92
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$454.15
|
| Rate for Payer: Cofinity Commercial |
$488.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.92
|
| Rate for Payer: Mclaren Medicaid |
$223.44
|
| Rate for Payer: Meridian Medicaid |
$234.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$355.87
|
| Rate for Payer: PACE SWMI |
$338.92
|
| Rate for Payer: PHP Medicare Advantage |
$338.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.84
|
| Rate for Payer: Priority Health Medicare |
$338.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$613.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$338.92
|
| Rate for Payer: UHC Medicare Advantage |
$349.09
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,767.00
|
|
|
Service Code
|
HCPCS 25109
|
| Min. Negotiated Rate |
$349.53 |
| Max. Negotiated Rate |
$1,326.56 |
| Rate for Payer: Aetna Commercial |
$709.86
|
| Rate for Payer: Aetna Medicare |
$550.94
|
| Rate for Payer: BCBS Complete |
$367.01
|
| Rate for Payer: BCBS MAPPO |
$529.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$529.75
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$709.86
|
| Rate for Payer: Cofinity Commercial |
$762.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.75
|
| Rate for Payer: Mclaren Medicaid |
$349.53
|
| Rate for Payer: Meridian Medicaid |
$367.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.24
|
| Rate for Payer: PACE SWMI |
$529.75
|
| Rate for Payer: PHP Medicare Advantage |
$529.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.81
|
| Rate for Payer: Priority Health Medicare |
$529.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$829.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.75
|
| Rate for Payer: UHC Medicare Advantage |
$545.64
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,767.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$419.66 |
| Max. Negotiated Rate |
$2,229.50 |
| Rate for Payer: Aetna Commercial |
$1,501.95
|
| Rate for Payer: Aetna Medicare |
$459.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$552.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$552.19
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$441.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,373.84
|
| Rate for Payer: BCN Commercial |
$1,373.84
|
| Rate for Payer: BCN Medicare Advantage |
$441.75
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$1,519.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,413.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.75
|
| Rate for Payer: Healthscope Commercial |
$1,590.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,325.25
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$463.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$508.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,501.95
|
| Rate for Payer: PACE Senior Care Partners |
$419.66
|
| Rate for Payer: PACE SWMI |
$441.75
|
| Rate for Payer: PHP Commercial |
$1,501.95
|
| Rate for Payer: PHP Medicare Advantage |
$441.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,537.29
|
| Rate for Payer: Priority Health Medicare |
$441.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,077.69
|
| Rate for Payer: Railroad Medicare Medicare |
$441.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,554.96
|
| Rate for Payer: UHC Core |
$1,475.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.75
|
| Rate for Payer: UHC Medicare Advantage |
$455.00
|
| Rate for Payer: VA VA |
$441.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,325.25
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,767.00
|
|
|
Service Code
|
HCPCS 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$349.53 |
| Max. Negotiated Rate |
$1,326.56 |
| Rate for Payer: Aetna Commercial |
$709.86
|
| Rate for Payer: Aetna Medicare |
$550.94
|
| Rate for Payer: BCBS Complete |
$367.01
|
| Rate for Payer: BCBS MAPPO |
$529.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,326.56
|
| Rate for Payer: BCN Commercial |
$794.10
|
| Rate for Payer: BCN Medicare Advantage |
$529.75
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$762.84
|
| Rate for Payer: Cofinity Commercial |
$709.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.75
|
| Rate for Payer: Mclaren Medicaid |
$349.53
|
| Rate for Payer: Meridian Medicaid |
$367.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.24
|
| Rate for Payer: PACE SWMI |
$529.75
|
| Rate for Payer: PHP Medicare Advantage |
$529.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$829.81
|
| Rate for Payer: Priority Health Medicare |
$529.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$829.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.75
|
| Rate for Payer: UHC Medicare Advantage |
$545.64
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,767.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$1,077.69 |
| Max. Negotiated Rate |
$1,590.30 |
| Rate for Payer: Aetna Commercial |
$1,501.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,365.54
|
| Rate for Payer: BCN Commercial |
$1,365.54
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$1,519.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,413.60
|
| Rate for Payer: Healthscope Commercial |
$1,590.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,325.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,501.95
|
| Rate for Payer: PHP Commercial |
$1,501.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,537.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,077.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,554.96
|
| Rate for Payer: UHC Core |
$1,475.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,325.25
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$73.06 |
| Max. Negotiated Rate |
$2,226.78 |
| Rate for Payer: Aetna Commercial |
$148.47
|
| Rate for Payer: Aetna Medicare |
$115.23
|
| Rate for Payer: BCBS Complete |
$76.71
|
| Rate for Payer: BCBS MAPPO |
$110.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.78
|
| Rate for Payer: BCN Commercial |
$314.22
|
| Rate for Payer: BCN Medicare Advantage |
$110.80
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$148.47
|
| Rate for Payer: Cofinity Commercial |
$159.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.80
|
| Rate for Payer: Mclaren Medicaid |
$73.06
|
| Rate for Payer: Meridian Medicaid |
$76.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.34
|
| Rate for Payer: PACE SWMI |
$110.80
|
| Rate for Payer: PHP Medicare Advantage |
$110.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.74
|
| Rate for Payer: Priority Health Medicare |
$110.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.80
|
| Rate for Payer: UHC Medicare Advantage |
$114.12
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$833.86
|
| Rate for Payer: Aetna Medicare |
$647.17
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$622.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$933.86
|
| Rate for Payer: BCN Medicare Advantage |
$622.28
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$896.08
|
| Rate for Payer: Cofinity Commercial |
$833.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.28
|
| Rate for Payer: Mclaren Medicaid |
$409.17
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$653.39
|
| Rate for Payer: PACE SWMI |
$622.28
|
| Rate for Payer: PHP Medicare Advantage |
$622.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.49
|
| Rate for Payer: Priority Health Medicare |
$622.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$785.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$622.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$622.28
|
| Rate for Payer: UHC Medicare Advantage |
$640.95
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$1,702.06 |
| Rate for Payer: Aetna Commercial |
$1,533.04
|
| Rate for Payer: Aetna Medicare |
$1,189.82
|
| Rate for Payer: BCBS Complete |
$797.98
|
| Rate for Payer: BCBS MAPPO |
$1,144.06
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$1,702.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,144.06
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cofinity Commercial |
$1,533.04
|
| Rate for Payer: Cofinity Commercial |
$1,647.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,144.06
|
| Rate for Payer: Mclaren Medicaid |
$759.98
|
| Rate for Payer: Meridian Medicaid |
$797.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,201.26
|
| Rate for Payer: PACE SWMI |
$1,144.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,144.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.65
|
| Rate for Payer: Priority Health Medicare |
$1,144.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,431.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,144.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,144.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,178.38
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,184.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$518.70 |
| Max. Negotiated Rate |
$1,965.60 |
| Rate for Payer: Aetna Commercial |
$1,856.40
|
| Rate for Payer: Aetna Medicare |
$567.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.50
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$546.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,698.06
|
| Rate for Payer: BCN Commercial |
$1,698.06
|
| Rate for Payer: BCN Medicare Advantage |
$546.00
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$1,878.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.00
|
| Rate for Payer: Healthscope Commercial |
$1,965.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.00
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$573.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$627.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,856.40
|
| Rate for Payer: PACE Senior Care Partners |
$518.70
|
| Rate for Payer: PACE SWMI |
$546.00
|
| Rate for Payer: PHP Commercial |
$1,856.40
|
| Rate for Payer: PHP Medicare Advantage |
$546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,900.08
|
| Rate for Payer: Priority Health Medicare |
$546.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,332.02
|
| Rate for Payer: Railroad Medicare Medicare |
$546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,921.92
|
| Rate for Payer: UHC Core |
$1,823.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.00
|
| Rate for Payer: UHC Medicare Advantage |
$562.38
|
| Rate for Payer: VA VA |
$546.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,528.80 |
| Rate for Payer: Aetna Commercial |
$709.84
|
| Rate for Payer: Aetna Medicare |
$550.92
|
| Rate for Payer: BCBS Complete |
$365.22
|
| Rate for Payer: BCBS MAPPO |
$529.73
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$529.73
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$762.81
|
| Rate for Payer: Cofinity Commercial |
$709.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.73
|
| Rate for Payer: Mclaren Medicaid |
$347.83
|
| Rate for Payer: Meridian Medicaid |
$365.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.22
|
| Rate for Payer: PACE SWMI |
$529.73
|
| Rate for Payer: PHP Medicare Advantage |
$529.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.25
|
| Rate for Payer: Priority Health Medicare |
$529.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.73
|
| Rate for Payer: UHC Medicare Advantage |
$545.62
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,528.80 |
| Rate for Payer: Aetna Commercial |
$709.84
|
| Rate for Payer: Aetna Medicare |
$550.92
|
| Rate for Payer: BCBS Complete |
$365.22
|
| Rate for Payer: BCBS MAPPO |
$529.73
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$529.73
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$709.84
|
| Rate for Payer: Cofinity Commercial |
$762.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.73
|
| Rate for Payer: Mclaren Medicaid |
$347.83
|
| Rate for Payer: Meridian Medicaid |
$365.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.22
|
| Rate for Payer: PACE SWMI |
$529.73
|
| Rate for Payer: PHP Medicare Advantage |
$529.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.25
|
| Rate for Payer: Priority Health Medicare |
$529.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.73
|
| Rate for Payer: UHC Medicare Advantage |
$545.62
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,184.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$1,332.02 |
| Max. Negotiated Rate |
$1,965.60 |
| Rate for Payer: Aetna Commercial |
$1,856.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,687.80
|
| Rate for Payer: BCN Commercial |
$1,687.80
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$1,878.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.20
|
| Rate for Payer: Healthscope Commercial |
$1,965.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,856.40
|
| Rate for Payer: PHP Commercial |
$1,856.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,900.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,332.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,921.92
|
| Rate for Payer: UHC Core |
$1,823.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.00
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$737.37 |
| Max. Negotiated Rate |
$1,088.10 |
| Rate for Payer: Aetna Commercial |
$1,027.65
|
| Rate for Payer: BCBS Trust/PPO |
$934.32
|
| Rate for Payer: BCN Commercial |
$934.32
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$1,039.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.20
|
| Rate for Payer: Healthscope Commercial |
$1,088.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,027.65
|
| Rate for Payer: PHP Commercial |
$1,027.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,051.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$737.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.92
|
| Rate for Payer: UHC Core |
$1,009.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$593.30
|
| Rate for Payer: Aetna Medicare |
$460.47
|
| Rate for Payer: BCBS Complete |
$303.27
|
| Rate for Payer: BCBS MAPPO |
$442.76
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$442.76
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$593.30
|
| Rate for Payer: Cofinity Commercial |
$637.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.76
|
| Rate for Payer: Mclaren Medicaid |
$288.83
|
| Rate for Payer: Meridian Medicaid |
$303.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.90
|
| Rate for Payer: PACE SWMI |
$442.76
|
| Rate for Payer: PHP Medicare Advantage |
$442.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.31
|
| Rate for Payer: Priority Health Medicare |
$442.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$442.76
|
| Rate for Payer: UHC Medicare Advantage |
$456.04
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$287.14 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$1,027.65
|
| Rate for Payer: Aetna Medicare |
$314.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$377.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$377.81
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$302.25
|
| Rate for Payer: BCBS Trust/PPO |
$940.00
|
| Rate for Payer: BCN Commercial |
$940.00
|
| Rate for Payer: BCN Medicare Advantage |
$302.25
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$1,039.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.25
|
| Rate for Payer: Healthscope Commercial |
$1,088.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.75
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$317.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,027.65
|
| Rate for Payer: PACE Senior Care Partners |
$287.14
|
| Rate for Payer: PACE SWMI |
$302.25
|
| Rate for Payer: PHP Commercial |
$1,027.65
|
| Rate for Payer: PHP Medicare Advantage |
$302.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,051.83
|
| Rate for Payer: Priority Health Medicare |
$302.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$737.37
|
| Rate for Payer: Railroad Medicare Medicare |
$302.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.92
|
| Rate for Payer: UHC Core |
$1,009.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.25
|
| Rate for Payer: UHC Medicare Advantage |
$311.32
|
| Rate for Payer: VA VA |
$302.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$593.30
|
| Rate for Payer: Aetna Medicare |
$460.47
|
| Rate for Payer: BCBS Complete |
$303.27
|
| Rate for Payer: BCBS MAPPO |
$442.76
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$442.76
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$593.30
|
| Rate for Payer: Cofinity Commercial |
$637.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.76
|
| Rate for Payer: Mclaren Medicaid |
$288.83
|
| Rate for Payer: Meridian Medicaid |
$303.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.90
|
| Rate for Payer: PACE SWMI |
$442.76
|
| Rate for Payer: PHP Medicare Advantage |
$442.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.31
|
| Rate for Payer: Priority Health Medicare |
$442.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$442.76
|
| Rate for Payer: UHC Medicare Advantage |
$456.04
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,131.09 |
| Rate for Payer: Aetna Commercial |
$980.37
|
| Rate for Payer: Aetna Medicare |
$760.88
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$731.62
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$731.62
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$980.37
|
| Rate for Payer: Cofinity Commercial |
$1,053.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.62
|
| Rate for Payer: Mclaren Medicaid |
$474.78
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.20
|
| Rate for Payer: PACE SWMI |
$731.62
|
| Rate for Payer: PHP Medicare Advantage |
$731.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.09
|
| Rate for Payer: Priority Health Medicare |
$731.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,131.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.62
|
| Rate for Payer: UHC Medicare Advantage |
$753.57
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,162.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$708.70 |
| Max. Negotiated Rate |
$1,045.80 |
| Rate for Payer: Aetna Commercial |
$987.70
|
| Rate for Payer: BCBS Trust/PPO |
$897.99
|
| Rate for Payer: BCN Commercial |
$897.99
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$999.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Healthscope Commercial |
$1,045.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$987.70
|
| Rate for Payer: PHP Commercial |
$987.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.56
|
| Rate for Payer: UHC Core |
$970.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.50
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,162.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$275.98 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$987.70
|
| Rate for Payer: Aetna Medicare |
$302.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$363.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$363.12
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$290.50
|
| Rate for Payer: BCBS Trust/PPO |
$903.46
|
| Rate for Payer: BCN Commercial |
$903.46
|
| Rate for Payer: BCN Medicare Advantage |
$290.50
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$999.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.50
|
| Rate for Payer: Healthscope Commercial |
$1,045.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.50
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$305.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$334.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$987.70
|
| Rate for Payer: PACE Senior Care Partners |
$275.98
|
| Rate for Payer: PACE SWMI |
$290.50
|
| Rate for Payer: PHP Commercial |
$987.70
|
| Rate for Payer: PHP Medicare Advantage |
$290.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,010.94
|
| Rate for Payer: Priority Health Medicare |
$290.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.70
|
| Rate for Payer: Railroad Medicare Medicare |
$290.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.56
|
| Rate for Payer: UHC Core |
$970.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.50
|
| Rate for Payer: UHC Medicare Advantage |
$299.22
|
| Rate for Payer: VA VA |
$290.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.50
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,131.09 |
| Rate for Payer: Aetna Commercial |
$980.37
|
| Rate for Payer: Aetna Medicare |
$760.88
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$731.62
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$731.62
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$980.37
|
| Rate for Payer: Cofinity Commercial |
$1,053.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.62
|
| Rate for Payer: Mclaren Medicaid |
$474.78
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.20
|
| Rate for Payer: PACE SWMI |
$731.62
|
| Rate for Payer: PHP Medicare Advantage |
$731.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.09
|
| Rate for Payer: Priority Health Medicare |
$731.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,131.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.62
|
| Rate for Payer: UHC Medicare Advantage |
$753.57
|
|
