|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$676.11 |
| Rate for Payer: Aetna Commercial |
$584.99
|
| Rate for Payer: Aetna Medicare |
$454.02
|
| Rate for Payer: BCBS Complete |
$298.58
|
| Rate for Payer: BCBS MAPPO |
$436.56
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: BCN Medicare Advantage |
$436.56
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$628.65
|
| Rate for Payer: Cofinity Commercial |
$584.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.56
|
| Rate for Payer: Mclaren Medicaid |
$284.36
|
| Rate for Payer: Meridian Medicaid |
$298.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$458.39
|
| Rate for Payer: PACE SWMI |
$436.56
|
| Rate for Payer: PHP Medicare Advantage |
$436.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.11
|
| Rate for Payer: Priority Health Medicare |
$436.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$676.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.56
|
| Rate for Payer: UHC Medicare Advantage |
$449.66
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$166.25 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$595.00
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.75
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$175.00
|
| Rate for Payer: BCBS Trust/PPO |
$544.25
|
| Rate for Payer: BCN Commercial |
$544.25
|
| Rate for Payer: BCN Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$560.00
|
| 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: Health Alliance Plan Medicare Advantage |
$175.00
|
| Rate for Payer: Healthscope Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.00
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.00
|
| Rate for Payer: PACE Senior Care Partners |
$166.25
|
| Rate for Payer: PACE SWMI |
$175.00
|
| Rate for Payer: PHP Commercial |
$595.00
|
| Rate for Payer: PHP Medicare Advantage |
$175.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| 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 Medicare |
$175.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.93
|
| Rate for Payer: Railroad Medicare Medicare |
$175.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.00
|
| Rate for Payer: UHC Core |
$584.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.00
|
| Rate for Payer: UHC Medicare Advantage |
$180.25
|
| Rate for Payer: VA VA |
$175.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.00
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$700.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$676.11 |
| Rate for Payer: Aetna Commercial |
$584.99
|
| Rate for Payer: Aetna Medicare |
$454.02
|
| Rate for Payer: BCBS Complete |
$298.58
|
| Rate for Payer: BCBS MAPPO |
$436.56
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: BCN Medicare Advantage |
$436.56
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$628.65
|
| Rate for Payer: Cofinity Commercial |
$584.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.56
|
| Rate for Payer: Mclaren Medicaid |
$284.36
|
| Rate for Payer: Meridian Medicaid |
$298.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$458.39
|
| Rate for Payer: PACE SWMI |
$436.56
|
| Rate for Payer: PHP Medicare Advantage |
$436.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.11
|
| Rate for Payer: Priority Health Medicare |
$436.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$676.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$436.56
|
| Rate for Payer: UHC Medicare Advantage |
$449.66
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$775.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$216.41 |
| Max. Negotiated Rate |
$694.90 |
| Rate for Payer: Aetna Commercial |
$440.42
|
| Rate for Payer: Aetna Medicare |
$341.82
|
| Rate for Payer: BCBS Complete |
$227.23
|
| Rate for Payer: BCBS MAPPO |
$328.67
|
| Rate for Payer: BCBS Trust/PPO |
$216.50
|
| Rate for Payer: BCN Commercial |
$694.90
|
| Rate for Payer: BCN Medicare Advantage |
$328.67
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cofinity Commercial |
$440.42
|
| Rate for Payer: Cofinity Commercial |
$473.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.67
|
| Rate for Payer: Mclaren Medicaid |
$216.41
|
| Rate for Payer: Meridian Medicaid |
$227.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$345.10
|
| Rate for Payer: PACE SWMI |
$328.67
|
| Rate for Payer: PHP Medicare Advantage |
$328.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$542.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$512.18
|
| Rate for Payer: Priority Health Medicare |
$328.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.67
|
| Rate for Payer: UHC Medicare Advantage |
$338.53
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$290.32 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$590.94
|
| Rate for Payer: Aetna Medicare |
$458.64
|
| Rate for Payer: BCBS Complete |
$304.84
|
| Rate for Payer: BCBS MAPPO |
$441.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$441.00
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$635.04
|
| Rate for Payer: Cofinity Commercial |
$590.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.00
|
| Rate for Payer: Mclaren Medicaid |
$290.32
|
| Rate for Payer: Meridian Medicaid |
$304.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$463.05
|
| Rate for Payer: PACE SWMI |
$441.00
|
| Rate for Payer: PHP Medicare Advantage |
$441.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.31
|
| Rate for Payer: Priority Health Medicare |
$441.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.00
|
| Rate for Payer: UHC Medicare Advantage |
$454.23
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
OP
|
$1,182.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$280.72 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$1,004.70
|
| Rate for Payer: Aetna Medicare |
$307.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$369.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$369.38
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$295.50
|
| Rate for Payer: BCBS Trust/PPO |
$919.00
|
| Rate for Payer: BCN Commercial |
$919.00
|
| Rate for Payer: BCN Medicare Advantage |
$295.50
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,016.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$945.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.50
|
| Rate for Payer: Healthscope Commercial |
$1,063.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$886.50
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$310.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$339.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,004.70
|
| Rate for Payer: PACE Senior Care Partners |
$280.72
|
| Rate for Payer: PACE SWMI |
$295.50
|
| Rate for Payer: PHP Commercial |
$1,004.70
|
| Rate for Payer: PHP Medicare Advantage |
$295.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,028.34
|
| Rate for Payer: Priority Health Medicare |
$295.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$720.90
|
| Rate for Payer: Railroad Medicare Medicare |
$295.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.16
|
| Rate for Payer: UHC Core |
$986.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.50
|
| Rate for Payer: UHC Medicare Advantage |
$304.36
|
| Rate for Payer: VA VA |
$295.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$886.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,182.00
|
|
|
Service Code
|
HCPCS 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$290.32 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$590.94
|
| Rate for Payer: Aetna Medicare |
$458.64
|
| Rate for Payer: BCBS Complete |
$304.84
|
| Rate for Payer: BCBS MAPPO |
$441.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$441.00
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$590.94
|
| Rate for Payer: Cofinity Commercial |
$635.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$441.00
|
| Rate for Payer: Mclaren Medicaid |
$290.32
|
| Rate for Payer: Meridian Medicaid |
$304.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$463.05
|
| Rate for Payer: PACE SWMI |
$441.00
|
| Rate for Payer: PHP Medicare Advantage |
$441.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.31
|
| Rate for Payer: Priority Health Medicare |
$441.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$441.00
|
| Rate for Payer: UHC Medicare Advantage |
$454.23
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
IP
|
$1,182.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$720.90 |
| Max. Negotiated Rate |
$1,063.80 |
| Rate for Payer: Aetna Commercial |
$1,004.70
|
| Rate for Payer: BCBS Trust/PPO |
$913.45
|
| Rate for Payer: BCN Commercial |
$913.45
|
| Rate for Payer: Cash Price |
$945.60
|
| Rate for Payer: Cofinity Commercial |
$1,016.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$945.60
|
| Rate for Payer: Healthscope Commercial |
$1,063.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$886.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,004.70
|
| Rate for Payer: PHP Commercial |
$1,004.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$827.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,028.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$720.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.16
|
| Rate for Payer: UHC Core |
$986.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$886.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$864.00
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$700.27 |
| Rate for Payer: Aetna Commercial |
$454.98
|
| Rate for Payer: Aetna Medicare |
$353.12
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$339.54
|
| Rate for Payer: BCBS Trust/PPO |
$699.47
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$339.54
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cash Price |
$691.20
|
| Rate for Payer: Cofinity Commercial |
$488.94
|
| Rate for Payer: Cofinity Commercial |
$454.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.54
|
| Rate for Payer: Mclaren Medicaid |
$223.65
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$356.52
|
| Rate for Payer: PACE SWMI |
$339.54
|
| Rate for Payer: PHP Medicare Advantage |
$339.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.54
|
| Rate for Payer: Priority Health Medicare |
$339.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.54
|
| Rate for Payer: UHC Medicare Advantage |
$349.73
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
IP
|
$1,152.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$702.60 |
| Max. Negotiated Rate |
$1,036.80 |
| Rate for Payer: Aetna Commercial |
$979.20
|
| Rate for Payer: BCBS Trust/PPO |
$890.27
|
| Rate for Payer: BCN Commercial |
$890.27
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$990.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.60
|
| Rate for Payer: Healthscope Commercial |
$1,036.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$979.20
|
| Rate for Payer: PHP Commercial |
$979.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,013.76
|
| Rate for Payer: UHC Core |
$961.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.00
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
OP
|
$1,152.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$273.60 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$979.20
|
| Rate for Payer: Aetna Medicare |
$299.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.00
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$288.00
|
| Rate for Payer: BCBS Trust/PPO |
$895.68
|
| Rate for Payer: BCN Commercial |
$895.68
|
| Rate for Payer: BCN Medicare Advantage |
$288.00
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$990.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$921.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.00
|
| Rate for Payer: Healthscope Commercial |
$1,036.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.00
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$979.20
|
| Rate for Payer: PACE Senior Care Partners |
$273.60
|
| Rate for Payer: PACE SWMI |
$288.00
|
| Rate for Payer: PHP Commercial |
$979.20
|
| Rate for Payer: PHP Medicare Advantage |
$288.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,002.24
|
| Rate for Payer: Priority Health Medicare |
$288.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.60
|
| Rate for Payer: Railroad Medicare Medicare |
$288.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,013.76
|
| Rate for Payer: UHC Core |
$961.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.00
|
| Rate for Payer: UHC Medicare Advantage |
$296.64
|
| Rate for Payer: VA VA |
$288.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.00
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 25075
|
| Hospital Charge Code |
25075
|
| Min. Negotiated Rate |
$205.55 |
| Max. Negotiated Rate |
$1,151.69 |
| Rate for Payer: Aetna Commercial |
$416.98
|
| Rate for Payer: Aetna Medicare |
$323.63
|
| Rate for Payer: BCBS Complete |
$215.83
|
| Rate for Payer: BCBS MAPPO |
$311.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.69
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: BCN Medicare Advantage |
$311.18
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$448.10
|
| Rate for Payer: Cofinity Commercial |
$416.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.18
|
| Rate for Payer: Mclaren Medicaid |
$205.55
|
| Rate for Payer: Meridian Medicaid |
$215.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.74
|
| Rate for Payer: PACE SWMI |
$311.18
|
| Rate for Payer: PHP Medicare Advantage |
$311.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$487.67
|
| Rate for Payer: Priority Health Medicare |
$311.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.52
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,152.00
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$205.55 |
| Max. Negotiated Rate |
$1,151.69 |
| Rate for Payer: Aetna Commercial |
$416.98
|
| Rate for Payer: Aetna Medicare |
$323.63
|
| Rate for Payer: BCBS Complete |
$215.83
|
| Rate for Payer: BCBS MAPPO |
$311.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.69
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: BCN Medicare Advantage |
$311.18
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cofinity Commercial |
$416.98
|
| Rate for Payer: Cofinity Commercial |
$448.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.18
|
| Rate for Payer: Mclaren Medicaid |
$205.55
|
| Rate for Payer: Meridian Medicaid |
$215.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.74
|
| Rate for Payer: PACE SWMI |
$311.18
|
| Rate for Payer: PHP Medicare Advantage |
$311.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$806.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$487.67
|
| Rate for Payer: Priority Health Medicare |
$311.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.18
|
| Rate for Payer: UHC Medicare Advantage |
$320.52
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,338.00
|
|
|
Service Code
|
HCPCS 27634
|
| Min. Negotiated Rate |
$433.24 |
| Max. Negotiated Rate |
$1,636.60 |
| Rate for Payer: Aetna Commercial |
$895.39
|
| Rate for Payer: Aetna Medicare |
$694.93
|
| Rate for Payer: BCBS Complete |
$454.90
|
| Rate for Payer: BCBS MAPPO |
$668.20
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$992.02
|
| Rate for Payer: BCN Medicare Advantage |
$668.20
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cofinity Commercial |
$962.21
|
| Rate for Payer: Cofinity Commercial |
$895.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.20
|
| Rate for Payer: Mclaren Medicaid |
$433.24
|
| Rate for Payer: Meridian Medicaid |
$454.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$701.61
|
| Rate for Payer: PACE SWMI |
$668.20
|
| Rate for Payer: PHP Medicare Advantage |
$668.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,036.62
|
| Rate for Payer: Priority Health Medicare |
$668.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,036.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$668.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.20
|
| Rate for Payer: UHC Medicare Advantage |
$688.25
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,223.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$304.38 |
| Max. Negotiated Rate |
$1,538.94 |
| Rate for Payer: Aetna Commercial |
$618.17
|
| Rate for Payer: Aetna Medicare |
$479.77
|
| Rate for Payer: BCBS Complete |
$319.60
|
| Rate for Payer: BCBS MAPPO |
$461.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,538.94
|
| Rate for Payer: BCN Commercial |
$687.08
|
| Rate for Payer: BCN Medicare Advantage |
$461.32
|
| Rate for Payer: Cash Price |
$978.40
|
| Rate for Payer: Cash Price |
$978.40
|
| Rate for Payer: Cofinity Commercial |
$664.30
|
| Rate for Payer: Cofinity Commercial |
$618.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$461.32
|
| Rate for Payer: Mclaren Medicaid |
$304.38
|
| Rate for Payer: Meridian Medicaid |
$319.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$484.39
|
| Rate for Payer: PACE SWMI |
$461.32
|
| Rate for Payer: PHP Medicare Advantage |
$461.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$856.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$717.97
|
| Rate for Payer: Priority Health Medicare |
$461.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$717.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$461.32
|
| Rate for Payer: UHC Medicare Advantage |
$475.16
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,125.81 |
| Rate for Payer: Aetna Commercial |
$402.54
|
| Rate for Payer: Aetna Medicare |
$312.42
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$300.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$300.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cofinity Commercial |
$432.58
|
| Rate for Payer: Cofinity Commercial |
$402.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.40
|
| Rate for Payer: Mclaren Medicaid |
$198.52
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.42
|
| Rate for Payer: PACE SWMI |
$300.40
|
| Rate for Payer: PHP Medicare Advantage |
$300.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.31
|
| Rate for Payer: Priority Health Medicare |
$300.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.40
|
| Rate for Payer: UHC Medicare Advantage |
$309.41
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,125.81 |
| Rate for Payer: Aetna Commercial |
$402.54
|
| Rate for Payer: Aetna Medicare |
$312.42
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$300.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$300.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cofinity Commercial |
$432.58
|
| Rate for Payer: Cofinity Commercial |
$402.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.40
|
| Rate for Payer: Mclaren Medicaid |
$198.52
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.42
|
| Rate for Payer: PACE SWMI |
$300.40
|
| Rate for Payer: PHP Medicare Advantage |
$300.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.31
|
| Rate for Payer: Priority Health Medicare |
$300.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.40
|
| Rate for Payer: UHC Medicare Advantage |
$309.41
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
OP
|
$1,063.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$252.46 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$903.55
|
| Rate for Payer: Aetna Medicare |
$276.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$332.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$332.19
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$265.75
|
| Rate for Payer: BCBS Trust/PPO |
$826.48
|
| Rate for Payer: BCN Commercial |
$826.48
|
| Rate for Payer: BCN Medicare Advantage |
$265.75
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cofinity Commercial |
$914.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.75
|
| Rate for Payer: Healthscope Commercial |
$956.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$797.25
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$279.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.55
|
| Rate for Payer: PACE Senior Care Partners |
$252.46
|
| Rate for Payer: PACE SWMI |
$265.75
|
| Rate for Payer: PHP Commercial |
$903.55
|
| Rate for Payer: PHP Medicare Advantage |
$265.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.81
|
| Rate for Payer: Priority Health Medicare |
$265.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$648.32
|
| Rate for Payer: Railroad Medicare Medicare |
$265.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.44
|
| Rate for Payer: UHC Core |
$887.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$265.75
|
| Rate for Payer: UHC Medicare Advantage |
$273.72
|
| Rate for Payer: VA VA |
$265.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$797.25
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
IP
|
$1,063.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$648.32 |
| Max. Negotiated Rate |
$956.70 |
| Rate for Payer: Aetna Commercial |
$903.55
|
| Rate for Payer: BCBS Trust/PPO |
$821.49
|
| Rate for Payer: BCN Commercial |
$821.49
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cofinity Commercial |
$914.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.40
|
| Rate for Payer: Healthscope Commercial |
$956.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$797.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.55
|
| Rate for Payer: PHP Commercial |
$903.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$924.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$648.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.44
|
| Rate for Payer: UHC Core |
$887.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$797.25
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$187.62 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna Medicare |
$205.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.88
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$197.50
|
| Rate for Payer: BCBS Trust/PPO |
$614.22
|
| Rate for Payer: BCN Commercial |
$614.22
|
| Rate for Payer: BCN Medicare Advantage |
$197.50
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.50
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$207.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PACE Senior Care Partners |
$187.62
|
| Rate for Payer: PACE SWMI |
$197.50
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: PHP Medicare Advantage |
$197.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$687.30
|
| Rate for Payer: Priority Health Medicare |
$197.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.82
|
| Rate for Payer: Railroad Medicare Medicare |
$197.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.20
|
| Rate for Payer: UHC Core |
$659.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.50
|
| Rate for Payer: UHC Medicare Advantage |
$203.42
|
| Rate for Payer: VA VA |
$197.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$640.16 |
| Rate for Payer: Aetna Commercial |
$404.16
|
| Rate for Payer: Aetna Medicare |
$313.67
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$301.61
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$301.61
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$404.16
|
| Rate for Payer: Cofinity Commercial |
$434.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.61
|
| Rate for Payer: Mclaren Medicaid |
$198.94
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.69
|
| Rate for Payer: PACE SWMI |
$301.61
|
| Rate for Payer: PHP Medicare Advantage |
$301.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.84
|
| Rate for Payer: Priority Health Medicare |
$301.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.61
|
| Rate for Payer: UHC Medicare Advantage |
$310.66
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$640.16 |
| Rate for Payer: Aetna Commercial |
$404.16
|
| Rate for Payer: Aetna Medicare |
$313.67
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS MAPPO |
$301.61
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: BCN Medicare Advantage |
$301.61
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$404.16
|
| Rate for Payer: Cofinity Commercial |
$434.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.61
|
| Rate for Payer: Mclaren Medicaid |
$198.94
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.69
|
| Rate for Payer: PACE SWMI |
$301.61
|
| Rate for Payer: PHP Medicare Advantage |
$301.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.84
|
| Rate for Payer: Priority Health Medicare |
$301.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.61
|
| Rate for Payer: UHC Medicare Advantage |
$310.66
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$481.82 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: BCBS Trust/PPO |
$610.51
|
| Rate for Payer: BCN Commercial |
$610.51
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$687.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.20
|
| Rate for Payer: UHC Core |
$659.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,102.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$240.88 |
| Max. Negotiated Rate |
$1,471.40 |
| Rate for Payer: Aetna Commercial |
$970.19
|
| Rate for Payer: Aetna Medicare |
$752.98
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS MAPPO |
$724.02
|
| Rate for Payer: BCBS Trust/PPO |
$240.88
|
| Rate for Payer: BCN Commercial |
$1,072.16
|
| Rate for Payer: BCN Medicare Advantage |
$724.02
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cofinity Commercial |
$1,042.59
|
| Rate for Payer: Cofinity Commercial |
$970.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$724.02
|
| Rate for Payer: Mclaren Medicaid |
$470.73
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$760.22
|
| Rate for Payer: PACE SWMI |
$724.02
|
| Rate for Payer: PHP Medicare Advantage |
$724.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,120.37
|
| Rate for Payer: Priority Health Medicare |
$724.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,120.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$724.02
|
| Rate for Payer: UHC Medicare Advantage |
$745.74
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$499.22 |
| Max. Negotiated Rate |
$1,957.20 |
| Rate for Payer: Aetna Commercial |
$1,786.70
|
| Rate for Payer: Aetna Medicare |
$546.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.88
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$525.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,634.30
|
| Rate for Payer: BCN Commercial |
$1,634.30
|
| Rate for Payer: BCN Medicare Advantage |
$525.50
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cofinity Commercial |
$1,807.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.50
|
| Rate for Payer: Healthscope Commercial |
$1,891.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.50
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$604.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,786.70
|
| Rate for Payer: PACE Senior Care Partners |
$499.22
|
| Rate for Payer: PACE SWMI |
$525.50
|
| Rate for Payer: PHP Commercial |
$1,786.70
|
| Rate for Payer: PHP Medicare Advantage |
$525.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,828.74
|
| Rate for Payer: Priority Health Medicare |
$525.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,282.01
|
| Rate for Payer: Railroad Medicare Medicare |
$525.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,849.76
|
| Rate for Payer: UHC Core |
$1,755.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.50
|
| Rate for Payer: UHC Medicare Advantage |
$541.26
|
| Rate for Payer: VA VA |
$525.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.50
|
|
