|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,975.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,204.55 |
| Max. Negotiated Rate |
$1,777.50 |
| Rate for Payer: Aetna Commercial |
$1,678.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,526.28
|
| Rate for Payer: BCN Commercial |
$1,526.28
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$1,698.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.00
|
| Rate for Payer: Healthscope Commercial |
$1,777.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,678.75
|
| Rate for Payer: PHP Commercial |
$1,678.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,204.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,738.00
|
| Rate for Payer: UHC Core |
$1,649.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,975.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$469.06 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$1,678.75
|
| Rate for Payer: Aetna Medicare |
$513.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$617.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$617.19
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$493.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.56
|
| Rate for Payer: BCN Commercial |
$1,535.56
|
| Rate for Payer: BCN Medicare Advantage |
$493.75
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$1,698.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$493.75
|
| Rate for Payer: Healthscope Commercial |
$1,777.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,481.25
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$518.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$567.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,678.75
|
| Rate for Payer: PACE Senior Care Partners |
$469.06
|
| Rate for Payer: PACE SWMI |
$493.75
|
| Rate for Payer: PHP Commercial |
$1,678.75
|
| Rate for Payer: PHP Medicare Advantage |
$493.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,718.25
|
| Rate for Payer: Priority Health Medicare |
$493.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,204.55
|
| Rate for Payer: Railroad Medicare Medicare |
$493.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,738.00
|
| Rate for Payer: UHC Core |
$1,649.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$493.75
|
| Rate for Payer: UHC Medicare Advantage |
$508.56
|
| Rate for Payer: VA VA |
$493.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,481.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,975.00
|
|
|
Service Code
|
HCPCS 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,382.50 |
| Rate for Payer: Aetna Commercial |
$882.91
|
| Rate for Payer: Aetna Medicare |
$685.25
|
| Rate for Payer: BCBS Complete |
$448.19
|
| Rate for Payer: BCBS MAPPO |
$658.89
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$658.89
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Cofinity Commercial |
$948.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.89
|
| Rate for Payer: Mclaren Medicaid |
$426.85
|
| Rate for Payer: Meridian Medicaid |
$448.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$691.83
|
| Rate for Payer: PACE SWMI |
$658.89
|
| Rate for Payer: PHP Medicare Advantage |
$658.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.28
|
| Rate for Payer: Priority Health Medicare |
$658.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,020.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.89
|
| Rate for Payer: UHC Medicare Advantage |
$678.66
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,975.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,382.50 |
| Rate for Payer: Aetna Commercial |
$882.91
|
| Rate for Payer: Aetna Medicare |
$685.25
|
| Rate for Payer: BCBS Complete |
$448.19
|
| Rate for Payer: BCBS MAPPO |
$658.89
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$658.89
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.89
|
| Rate for Payer: Mclaren Medicaid |
$426.85
|
| Rate for Payer: Meridian Medicaid |
$448.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$691.83
|
| Rate for Payer: PACE SWMI |
$658.89
|
| Rate for Payer: PHP Medicare Advantage |
$658.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.28
|
| Rate for Payer: Priority Health Medicare |
$658.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,020.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.89
|
| Rate for Payer: UHC Medicare Advantage |
$678.66
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
IP
|
$866.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$528.17 |
| Max. Negotiated Rate |
$779.40 |
| Rate for Payer: Aetna Commercial |
$736.10
|
| Rate for Payer: BCBS Trust/PPO |
$669.24
|
| Rate for Payer: BCN Commercial |
$669.24
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$744.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.80
|
| Rate for Payer: Healthscope Commercial |
$779.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$649.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.10
|
| Rate for Payer: PHP Commercial |
$736.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$753.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.08
|
| Rate for Payer: UHC Core |
$723.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$649.50
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$866.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$336.11 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$687.76
|
| Rate for Payer: Aetna Medicare |
$533.78
|
| Rate for Payer: BCBS Complete |
$352.92
|
| Rate for Payer: BCBS MAPPO |
$513.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$513.25
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$739.08
|
| Rate for Payer: Cofinity Commercial |
$687.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.25
|
| Rate for Payer: Mclaren Medicaid |
$336.11
|
| Rate for Payer: Meridian Medicaid |
$352.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$538.91
|
| Rate for Payer: PACE SWMI |
$513.25
|
| Rate for Payer: PHP Medicare Advantage |
$513.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$801.21
|
| Rate for Payer: Priority Health Medicare |
$513.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.25
|
| Rate for Payer: UHC Medicare Advantage |
$528.65
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$866.00
|
|
|
Service Code
|
HCPCS 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$336.11 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$687.76
|
| Rate for Payer: Aetna Medicare |
$533.78
|
| Rate for Payer: BCBS Complete |
$352.92
|
| Rate for Payer: BCBS MAPPO |
$513.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$513.25
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$739.08
|
| Rate for Payer: Cofinity Commercial |
$687.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.25
|
| Rate for Payer: Mclaren Medicaid |
$336.11
|
| Rate for Payer: Meridian Medicaid |
$352.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$538.91
|
| Rate for Payer: PACE SWMI |
$513.25
|
| Rate for Payer: PHP Medicare Advantage |
$513.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$801.21
|
| Rate for Payer: Priority Health Medicare |
$513.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.25
|
| Rate for Payer: UHC Medicare Advantage |
$528.65
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
OP
|
$866.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$205.68 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$736.10
|
| Rate for Payer: Aetna Medicare |
$225.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.62
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$216.50
|
| Rate for Payer: BCBS Trust/PPO |
$673.32
|
| Rate for Payer: BCN Commercial |
$673.32
|
| Rate for Payer: BCN Medicare Advantage |
$216.50
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$744.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.50
|
| Rate for Payer: Healthscope Commercial |
$779.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$649.50
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.10
|
| Rate for Payer: PACE Senior Care Partners |
$205.68
|
| Rate for Payer: PACE SWMI |
$216.50
|
| Rate for Payer: PHP Commercial |
$736.10
|
| Rate for Payer: PHP Medicare Advantage |
$216.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$753.42
|
| Rate for Payer: Priority Health Medicare |
$216.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.17
|
| Rate for Payer: Railroad Medicare Medicare |
$216.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.08
|
| Rate for Payer: UHC Core |
$723.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.50
|
| Rate for Payer: UHC Medicare Advantage |
$223.00
|
| Rate for Payer: VA VA |
$216.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$649.50
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$916.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$259.22 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$529.23
|
| Rate for Payer: Aetna Medicare |
$410.75
|
| Rate for Payer: BCBS Complete |
$272.18
|
| Rate for Payer: BCBS MAPPO |
$394.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$789.70
|
| Rate for Payer: BCN Medicare Advantage |
$394.95
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cofinity Commercial |
$529.23
|
| Rate for Payer: Cofinity Commercial |
$568.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.95
|
| Rate for Payer: Mclaren Medicaid |
$259.22
|
| Rate for Payer: Meridian Medicaid |
$272.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$414.70
|
| Rate for Payer: PACE SWMI |
$394.95
|
| Rate for Payer: PHP Medicare Advantage |
$394.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$617.38
|
| Rate for Payer: Priority Health Medicare |
$394.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.95
|
| Rate for Payer: UHC Medicare Advantage |
$406.80
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,579.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$171.70 |
| Max. Negotiated Rate |
$1,105.30 |
| Rate for Payer: Aetna Commercial |
$561.59
|
| Rate for Payer: Aetna Medicare |
$435.86
|
| Rate for Payer: BCBS Complete |
$288.73
|
| Rate for Payer: BCBS MAPPO |
$419.10
|
| Rate for Payer: BCBS Trust/PPO |
$171.70
|
| Rate for Payer: BCN Commercial |
$624.04
|
| Rate for Payer: BCN Medicare Advantage |
$419.10
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Cash Price |
$1,263.20
|
| Rate for Payer: Cofinity Commercial |
$603.50
|
| Rate for Payer: Cofinity Commercial |
$561.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.10
|
| Rate for Payer: Mclaren Medicaid |
$274.98
|
| Rate for Payer: Meridian Medicaid |
$288.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.06
|
| Rate for Payer: PACE SWMI |
$419.10
|
| Rate for Payer: PHP Medicare Advantage |
$419.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.10
|
| Rate for Payer: Priority Health Medicare |
$419.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$419.10
|
| Rate for Payer: UHC Medicare Advantage |
$431.67
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,767.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$235.09 |
| Max. Negotiated Rate |
$1,236.90 |
| Rate for Payer: Aetna Commercial |
$686.29
|
| Rate for Payer: Aetna Medicare |
$532.65
|
| Rate for Payer: BCBS Complete |
$354.26
|
| Rate for Payer: BCBS MAPPO |
$512.16
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$767.22
|
| Rate for Payer: BCN Medicare Advantage |
$512.16
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$737.51
|
| Rate for Payer: Cofinity Commercial |
$686.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.16
|
| Rate for Payer: Mclaren Medicaid |
$337.39
|
| Rate for Payer: Meridian Medicaid |
$354.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$537.77
|
| Rate for Payer: PACE SWMI |
$512.16
|
| Rate for Payer: PHP Medicare Advantage |
$512.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$337.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$801.72
|
| Rate for Payer: Priority Health Medicare |
$512.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.16
|
| Rate for Payer: UHC Medicare Advantage |
$527.52
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,190.00 |
| Rate for Payer: Aetna Commercial |
$702.68
|
| Rate for Payer: Aetna Medicare |
$545.37
|
| Rate for Payer: BCBS Complete |
$358.73
|
| Rate for Payer: BCBS MAPPO |
$524.39
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$524.39
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$702.68
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.39
|
| Rate for Payer: Mclaren Medicaid |
$341.65
|
| Rate for Payer: Meridian Medicaid |
$358.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$550.61
|
| Rate for Payer: PACE SWMI |
$524.39
|
| Rate for Payer: PHP Medicare Advantage |
$524.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$815.51
|
| Rate for Payer: Priority Health Medicare |
$524.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$815.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.39
|
| Rate for Payer: UHC Medicare Advantage |
$540.12
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,190.00 |
| Rate for Payer: Aetna Commercial |
$702.68
|
| Rate for Payer: Aetna Medicare |
$545.37
|
| Rate for Payer: BCBS Complete |
$358.73
|
| Rate for Payer: BCBS MAPPO |
$524.39
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$524.39
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$755.12
|
| Rate for Payer: Cofinity Commercial |
$702.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.39
|
| Rate for Payer: Mclaren Medicaid |
$341.65
|
| Rate for Payer: Meridian Medicaid |
$358.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$550.61
|
| Rate for Payer: PACE SWMI |
$524.39
|
| Rate for Payer: PHP Medicare Advantage |
$524.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$815.51
|
| Rate for Payer: Priority Health Medicare |
$524.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$815.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.39
|
| Rate for Payer: UHC Medicare Advantage |
$540.12
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$403.75 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$1,445.00
|
| Rate for Payer: Aetna Medicare |
$442.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$531.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$531.25
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$425.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.75
|
| Rate for Payer: BCN Commercial |
$1,321.75
|
| Rate for Payer: BCN Medicare Advantage |
$425.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,462.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$425.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.00
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$446.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$488.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,445.00
|
| Rate for Payer: PACE Senior Care Partners |
$403.75
|
| Rate for Payer: PACE SWMI |
$425.00
|
| Rate for Payer: PHP Commercial |
$1,445.00
|
| Rate for Payer: PHP Medicare Advantage |
$425.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,479.00
|
| Rate for Payer: Priority Health Medicare |
$425.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,036.83
|
| Rate for Payer: Railroad Medicare Medicare |
$425.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.00
|
| Rate for Payer: UHC Core |
$1,419.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$425.00
|
| Rate for Payer: UHC Medicare Advantage |
$437.75
|
| Rate for Payer: VA VA |
$425.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.00
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,036.83 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Commercial |
$1,445.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,313.76
|
| Rate for Payer: BCN Commercial |
$1,313.76
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,462.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,360.00
|
| Rate for Payer: Healthscope Commercial |
$1,530.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,275.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,445.00
|
| Rate for Payer: PHP Commercial |
$1,445.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,479.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,036.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.00
|
| Rate for Payer: UHC Core |
$1,419.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,275.00
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,002.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$237.98 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$851.70
|
| Rate for Payer: Aetna Medicare |
$260.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.12
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$250.50
|
| Rate for Payer: BCBS Trust/PPO |
$779.06
|
| Rate for Payer: BCN Commercial |
$779.06
|
| Rate for Payer: BCN Medicare Advantage |
$250.50
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$861.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$801.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.50
|
| Rate for Payer: Healthscope Commercial |
$901.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$751.50
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$263.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.70
|
| Rate for Payer: PACE Senior Care Partners |
$237.98
|
| Rate for Payer: PACE SWMI |
$250.50
|
| Rate for Payer: PHP Commercial |
$851.70
|
| Rate for Payer: PHP Medicare Advantage |
$250.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.74
|
| Rate for Payer: Priority Health Medicare |
$250.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$611.12
|
| Rate for Payer: Railroad Medicare Medicare |
$250.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$881.76
|
| Rate for Payer: UHC Core |
$836.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.50
|
| Rate for Payer: UHC Medicare Advantage |
$258.02
|
| Rate for Payer: VA VA |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$751.50
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,002.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$835.93 |
| Rate for Payer: Aetna Commercial |
$719.12
|
| Rate for Payer: Aetna Medicare |
$558.13
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$536.66
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$536.66
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$772.79
|
| Rate for Payer: Cofinity Commercial |
$719.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.66
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: PACE SWMI |
$536.66
|
| Rate for Payer: PHP Medicare Advantage |
$536.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.93
|
| Rate for Payer: Priority Health Medicare |
$536.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$835.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.66
|
| Rate for Payer: UHC Medicare Advantage |
$552.76
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,002.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$835.93 |
| Rate for Payer: Aetna Commercial |
$719.12
|
| Rate for Payer: Aetna Medicare |
$558.13
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$536.66
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$536.66
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$772.79
|
| Rate for Payer: Cofinity Commercial |
$719.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.66
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$563.49
|
| Rate for Payer: PACE SWMI |
$536.66
|
| Rate for Payer: PHP Medicare Advantage |
$536.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$835.93
|
| Rate for Payer: Priority Health Medicare |
$536.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$835.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$536.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.66
|
| Rate for Payer: UHC Medicare Advantage |
$552.76
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,002.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$611.12 |
| Max. Negotiated Rate |
$901.80 |
| Rate for Payer: Aetna Commercial |
$851.70
|
| Rate for Payer: BCBS Trust/PPO |
$774.35
|
| Rate for Payer: BCN Commercial |
$774.35
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cofinity Commercial |
$861.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$801.60
|
| Rate for Payer: Healthscope Commercial |
$901.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$751.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.70
|
| Rate for Payer: PHP Commercial |
$851.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$701.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$611.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$881.76
|
| Rate for Payer: UHC Core |
$836.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$751.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,138.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$694.07 |
| Max. Negotiated Rate |
$1,024.20 |
| Rate for Payer: Aetna Commercial |
$967.30
|
| Rate for Payer: BCBS Trust/PPO |
$879.45
|
| Rate for Payer: BCN Commercial |
$879.45
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Healthscope Commercial |
$1,024.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$967.30
|
| Rate for Payer: PHP Commercial |
$967.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$694.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.44
|
| Rate for Payer: UHC Core |
$950.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,138.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$867.59 |
| Rate for Payer: Aetna Commercial |
$750.76
|
| Rate for Payer: Aetna Medicare |
$582.68
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS MAPPO |
$560.27
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$560.27
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$750.76
|
| Rate for Payer: Cofinity Commercial |
$806.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.27
|
| Rate for Payer: Mclaren Medicaid |
$365.30
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$588.28
|
| Rate for Payer: PACE SWMI |
$560.27
|
| Rate for Payer: PHP Medicare Advantage |
$560.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.59
|
| Rate for Payer: Priority Health Medicare |
$560.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$867.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.27
|
| Rate for Payer: UHC Medicare Advantage |
$577.08
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,138.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$270.28 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$967.30
|
| Rate for Payer: Aetna Medicare |
$295.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$355.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$355.62
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$284.50
|
| Rate for Payer: BCBS Trust/PPO |
$884.80
|
| Rate for Payer: BCN Commercial |
$884.80
|
| Rate for Payer: BCN Medicare Advantage |
$284.50
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$978.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$910.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.50
|
| Rate for Payer: Healthscope Commercial |
$1,024.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$853.50
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$298.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$967.30
|
| Rate for Payer: PACE Senior Care Partners |
$270.28
|
| Rate for Payer: PACE SWMI |
$284.50
|
| Rate for Payer: PHP Commercial |
$967.30
|
| Rate for Payer: PHP Medicare Advantage |
$284.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$990.06
|
| Rate for Payer: Priority Health Medicare |
$284.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$694.07
|
| Rate for Payer: Railroad Medicare Medicare |
$284.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,001.44
|
| Rate for Payer: UHC Core |
$950.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.50
|
| Rate for Payer: UHC Medicare Advantage |
$293.04
|
| Rate for Payer: VA VA |
$284.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$853.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,138.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$867.59 |
| Rate for Payer: Aetna Commercial |
$750.76
|
| Rate for Payer: Aetna Medicare |
$582.68
|
| Rate for Payer: BCBS Complete |
$383.56
|
| Rate for Payer: BCBS MAPPO |
$560.27
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$560.27
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cash Price |
$910.40
|
| Rate for Payer: Cofinity Commercial |
$806.79
|
| Rate for Payer: Cofinity Commercial |
$750.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$560.27
|
| Rate for Payer: Mclaren Medicaid |
$365.30
|
| Rate for Payer: Meridian Medicaid |
$383.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$588.28
|
| Rate for Payer: PACE SWMI |
$560.27
|
| Rate for Payer: PHP Medicare Advantage |
$560.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.59
|
| Rate for Payer: Priority Health Medicare |
$560.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$867.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$560.27
|
| Rate for Payer: UHC Medicare Advantage |
$577.08
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,179.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$132.44 |
| Max. Negotiated Rate |
$1,020.28 |
| Rate for Payer: Aetna Commercial |
$885.22
|
| Rate for Payer: Aetna Medicare |
$687.03
|
| Rate for Payer: BCBS Complete |
$450.66
|
| Rate for Payer: BCBS MAPPO |
$660.61
|
| Rate for Payer: BCBS Trust/PPO |
$132.44
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$660.61
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cofinity Commercial |
$951.28
|
| Rate for Payer: Cofinity Commercial |
$885.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$660.61
|
| Rate for Payer: Mclaren Medicaid |
$429.20
|
| Rate for Payer: Meridian Medicaid |
$450.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$693.64
|
| Rate for Payer: PACE SWMI |
$660.61
|
| Rate for Payer: PHP Medicare Advantage |
$660.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$825.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.28
|
| Rate for Payer: Priority Health Medicare |
$660.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,020.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$660.61
|
| Rate for Payer: UHC Medicare Advantage |
$680.43
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$426.93 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Commercial |
$595.00
|
| Rate for Payer: BCBS Trust/PPO |
$540.96
|
| Rate for Payer: BCN Commercial |
$540.96
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$602.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.00
|
| Rate for Payer: Healthscope Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.00
|
| Rate for Payer: PHP Commercial |
$595.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.00
|
| Rate for Payer: UHC Core |
$584.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.00
|
|
