PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$916.00
|
|
Service Code
|
HCPCS 64625
|
Min. Negotiated Rate |
$124.39 |
Max. Negotiated Rate |
$1,208.22 |
Rate for Payer: Aetna Commercial |
$253.81
|
Rate for Payer: Aetna Medicare |
$196.99
|
Rate for Payer: BCBS Complete |
$130.61
|
Rate for Payer: BCBS MAPPO |
$189.41
|
Rate for Payer: BCBS Trust/PPO |
$1,208.22
|
Rate for Payer: BCN Commercial |
$690.50
|
Rate for Payer: BCN Medicare Advantage |
$189.41
|
Rate for Payer: Cash Price |
$732.80
|
Rate for Payer: Cash Price |
$732.80
|
Rate for Payer: Cofinity Commercial |
$272.75
|
Rate for Payer: Cofinity Commercial |
$253.81
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.41
|
Rate for Payer: Mclaren Medicaid |
$124.39
|
Rate for Payer: Meridian Medicaid |
$130.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.88
|
Rate for Payer: PACE SWMI |
$189.41
|
Rate for Payer: PHP Medicare Advantage |
$189.41
|
Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$641.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.58
|
Rate for Payer: Priority Health Medicare |
$189.41
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$325.58
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$189.41
|
Rate for Payer: UHC Dual Complete DSNP |
$189.41
|
Rate for Payer: UHC Medicare Advantage |
$195.09
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$916.00
|
|
Service Code
|
HCPCS 64625
|
Hospital Charge Code |
64625
|
Min. Negotiated Rate |
$124.39 |
Max. Negotiated Rate |
$1,208.22 |
Rate for Payer: Aetna Commercial |
$253.81
|
Rate for Payer: Aetna Medicare |
$196.99
|
Rate for Payer: BCBS Complete |
$130.61
|
Rate for Payer: BCBS MAPPO |
$189.41
|
Rate for Payer: BCBS Trust/PPO |
$1,208.22
|
Rate for Payer: BCN Commercial |
$690.50
|
Rate for Payer: BCN Medicare Advantage |
$189.41
|
Rate for Payer: Cash Price |
$732.80
|
Rate for Payer: Cash Price |
$732.80
|
Rate for Payer: Cofinity Commercial |
$272.75
|
Rate for Payer: Cofinity Commercial |
$253.81
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.41
|
Rate for Payer: Mclaren Medicaid |
$124.39
|
Rate for Payer: Meridian Medicaid |
$130.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.88
|
Rate for Payer: PACE SWMI |
$189.41
|
Rate for Payer: PHP Medicare Advantage |
$189.41
|
Rate for Payer: Priority Health Choice Medicaid |
$124.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$641.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$325.58
|
Rate for Payer: Priority Health Medicare |
$189.41
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$325.58
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$189.41
|
Rate for Payer: UHC Dual Complete DSNP |
$189.41
|
Rate for Payer: UHC Medicare Advantage |
$195.09
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
IP
|
$916.00
|
|
Service Code
|
CPT 64625
|
Hospital Charge Code |
64625
|
Min. Negotiated Rate |
$558.67 |
Max. Negotiated Rate |
$824.40 |
Rate for Payer: Aetna Commercial |
$778.60
|
Rate for Payer: BCBS Trust/PPO |
$707.88
|
Rate for Payer: BCN Commercial |
$707.88
|
Rate for Payer: Cash Price |
$732.80
|
Rate for Payer: Cofinity Commercial |
$787.76
|
Rate for Payer: Encore Health Key Benefits Commercial |
$732.80
|
Rate for Payer: Healthscope Commercial |
$824.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$687.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$778.60
|
Rate for Payer: PHP Commercial |
$778.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$641.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$796.92
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$558.67
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$806.08
|
Rate for Payer: UHC Core |
$764.86
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$687.00
|
|
PR RAD RESCJ CAPSL TISS&HTRTPC B1 ELBW CONTRCT RLS
|
Professional
|
Both
|
$2,616.00
|
|
Service Code
|
HCPCS 24149
|
Min. Negotiated Rate |
$762.11 |
Max. Negotiated Rate |
$1,831.20 |
Rate for Payer: Aetna Commercial |
$1,555.67
|
Rate for Payer: Aetna Medicare |
$1,207.39
|
Rate for Payer: BCBS Complete |
$800.22
|
Rate for Payer: BCBS MAPPO |
$1,160.95
|
Rate for Payer: BCBS Trust/PPO |
$873.28
|
Rate for Payer: BCN Commercial |
$1,732.85
|
Rate for Payer: BCN Medicare Advantage |
$1,160.95
|
Rate for Payer: Cash Price |
$2,092.80
|
Rate for Payer: Cash Price |
$2,092.80
|
Rate for Payer: Cofinity Commercial |
$1,671.77
|
Rate for Payer: Cofinity Commercial |
$1,555.67
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.95
|
Rate for Payer: Mclaren Medicaid |
$762.11
|
Rate for Payer: Meridian Medicaid |
$800.22
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,219.00
|
Rate for Payer: PACE SWMI |
$1,160.95
|
Rate for Payer: PHP Medicare Advantage |
$1,160.95
|
Rate for Payer: Priority Health Choice Medicaid |
$762.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,831.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,810.76
|
Rate for Payer: Priority Health Medicare |
$1,160.95
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,810.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,160.95
|
Rate for Payer: UHC Dual Complete DSNP |
$1,160.95
|
Rate for Payer: UHC Medicare Advantage |
$1,195.78
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW <5CM
|
Professional
|
Both
|
$1,811.00
|
|
Service Code
|
HCPCS 24077
|
Min. Negotiated Rate |
$659.87 |
Max. Negotiated Rate |
$1,580.46 |
Rate for Payer: Aetna Commercial |
$1,369.63
|
Rate for Payer: Aetna Medicare |
$1,062.99
|
Rate for Payer: BCBS Complete |
$692.86
|
Rate for Payer: BCBS MAPPO |
$1,022.11
|
Rate for Payer: BCBS Trust/PPO |
$712.15
|
Rate for Payer: BCN Commercial |
$1,512.46
|
Rate for Payer: BCN Medicare Advantage |
$1,022.11
|
Rate for Payer: Cash Price |
$1,448.80
|
Rate for Payer: Cash Price |
$1,448.80
|
Rate for Payer: Cofinity Commercial |
$1,369.63
|
Rate for Payer: Cofinity Commercial |
$1,471.84
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.11
|
Rate for Payer: Mclaren Medicaid |
$659.87
|
Rate for Payer: Meridian Medicaid |
$692.86
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,073.22
|
Rate for Payer: PACE SWMI |
$1,022.11
|
Rate for Payer: PHP Medicare Advantage |
$1,022.11
|
Rate for Payer: Priority Health Choice Medicaid |
$659.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,267.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,580.46
|
Rate for Payer: Priority Health Medicare |
$1,022.11
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,580.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.11
|
Rate for Payer: UHC Dual Complete DSNP |
$1,022.11
|
Rate for Payer: UHC Medicare Advantage |
$1,052.77
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW 5CM+
|
Professional
|
Both
|
$3,056.00
|
|
Service Code
|
HCPCS 24079
|
Min. Negotiated Rate |
$849.66 |
Max. Negotiated Rate |
$2,139.20 |
Rate for Payer: Aetna Commercial |
$1,756.40
|
Rate for Payer: Aetna Medicare |
$1,363.18
|
Rate for Payer: BCBS Complete |
$892.14
|
Rate for Payer: BCBS MAPPO |
$1,310.75
|
Rate for Payer: BCBS Trust/PPO |
$918.19
|
Rate for Payer: BCN Commercial |
$1,935.66
|
Rate for Payer: BCN Medicare Advantage |
$1,310.75
|
Rate for Payer: Cash Price |
$2,444.80
|
Rate for Payer: Cash Price |
$2,444.80
|
Rate for Payer: Cofinity Commercial |
$1,887.48
|
Rate for Payer: Cofinity Commercial |
$1,756.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,310.75
|
Rate for Payer: Mclaren Medicaid |
$849.66
|
Rate for Payer: Meridian Medicaid |
$892.14
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,376.29
|
Rate for Payer: PACE SWMI |
$1,310.75
|
Rate for Payer: PHP Medicare Advantage |
$1,310.75
|
Rate for Payer: Priority Health Choice Medicaid |
$849.66
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,139.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,022.68
|
Rate for Payer: Priority Health Medicare |
$1,310.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,022.68
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,310.75
|
Rate for Payer: UHC Dual Complete DSNP |
$1,310.75
|
Rate for Payer: UHC Medicare Advantage |
$1,350.07
|
|
PR RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>
|
Professional
|
Both
|
$3,863.00
|
|
Service Code
|
HCPCS 25078
|
Min. Negotiated Rate |
$748.91 |
Max. Negotiated Rate |
$2,704.10 |
Rate for Payer: Aetna Commercial |
$1,545.45
|
Rate for Payer: Aetna Medicare |
$1,199.45
|
Rate for Payer: BCBS Complete |
$786.36
|
Rate for Payer: BCBS MAPPO |
$1,153.32
|
Rate for Payer: BCBS Trust/PPO |
$1,058.71
|
Rate for Payer: BCN Commercial |
$1,706.95
|
Rate for Payer: BCN Medicare Advantage |
$1,153.32
|
Rate for Payer: Cash Price |
$3,090.40
|
Rate for Payer: Cash Price |
$3,090.40
|
Rate for Payer: Cofinity Commercial |
$1,660.78
|
Rate for Payer: Cofinity Commercial |
$1,545.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,153.32
|
Rate for Payer: Mclaren Medicaid |
$748.91
|
Rate for Payer: Meridian Medicaid |
$786.36
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,210.99
|
Rate for Payer: PACE SWMI |
$1,153.32
|
Rate for Payer: PHP Medicare Advantage |
$1,153.32
|
Rate for Payer: Priority Health Choice Medicaid |
$748.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,704.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,783.70
|
Rate for Payer: Priority Health Medicare |
$1,153.32
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,783.70
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,153.32
|
Rate for Payer: UHC Dual Complete DSNP |
$1,153.32
|
Rate for Payer: UHC Medicare Advantage |
$1,187.92
|
|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$3,440.00
|
|
Service Code
|
HCPCS 26118
|
Min. Negotiated Rate |
$213.95 |
Max. Negotiated Rate |
$2,408.00 |
Rate for Payer: Aetna Commercial |
$1,391.62
|
Rate for Payer: Aetna Medicare |
$1,080.06
|
Rate for Payer: BCBS Complete |
$709.19
|
Rate for Payer: BCBS MAPPO |
$1,038.52
|
Rate for Payer: BCBS Trust/PPO |
$213.95
|
Rate for Payer: BCN Commercial |
$1,547.65
|
Rate for Payer: BCN Medicare Advantage |
$1,038.52
|
Rate for Payer: Cash Price |
$2,752.00
|
Rate for Payer: Cash Price |
$2,752.00
|
Rate for Payer: Cofinity Commercial |
$1,495.47
|
Rate for Payer: Cofinity Commercial |
$1,391.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,038.52
|
Rate for Payer: Mclaren Medicaid |
$675.42
|
Rate for Payer: Meridian Medicaid |
$709.19
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,090.45
|
Rate for Payer: PACE SWMI |
$1,038.52
|
Rate for Payer: PHP Medicare Advantage |
$1,038.52
|
Rate for Payer: Priority Health Choice Medicaid |
$675.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,408.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,617.23
|
Rate for Payer: Priority Health Medicare |
$1,038.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,617.23
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.52
|
Rate for Payer: UHC Dual Complete DSNP |
$1,038.52
|
Rate for Payer: UHC Medicare Advantage |
$1,069.68
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$4,187.00
|
|
Service Code
|
HCPCS 27075
|
Min. Negotiated Rate |
$572.15 |
Max. Negotiated Rate |
$3,168.07 |
Rate for Payer: Aetna Commercial |
$2,747.94
|
Rate for Payer: Aetna Medicare |
$2,132.73
|
Rate for Payer: BCBS Complete |
$1,395.12
|
Rate for Payer: BCBS MAPPO |
$2,050.70
|
Rate for Payer: BCBS Trust/PPO |
$572.15
|
Rate for Payer: BCN Commercial |
$3,031.75
|
Rate for Payer: BCN Medicare Advantage |
$2,050.70
|
Rate for Payer: Cash Price |
$3,349.60
|
Rate for Payer: Cash Price |
$3,349.60
|
Rate for Payer: Cofinity Commercial |
$2,747.94
|
Rate for Payer: Cofinity Commercial |
$2,953.01
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.70
|
Rate for Payer: Mclaren Medicaid |
$1,328.69
|
Rate for Payer: Meridian Medicaid |
$1,395.12
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,153.24
|
Rate for Payer: PACE SWMI |
$2,050.70
|
Rate for Payer: PHP Medicare Advantage |
$2,050.70
|
Rate for Payer: Priority Health Choice Medicaid |
$1,328.69
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,930.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,168.07
|
Rate for Payer: Priority Health Medicare |
$2,050.70
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3,168.07
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,050.70
|
Rate for Payer: UHC Dual Complete DSNP |
$2,050.70
|
Rate for Payer: UHC Medicare Advantage |
$2,112.22
|
|
PR RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,614.00
|
|
Service Code
|
HCPCS 26260
|
Min. Negotiated Rate |
$278.41 |
Max. Negotiated Rate |
$1,224.55 |
Rate for Payer: Aetna Commercial |
$1,054.03
|
Rate for Payer: Aetna Medicare |
$818.05
|
Rate for Payer: BCBS Complete |
$540.78
|
Rate for Payer: BCBS MAPPO |
$786.59
|
Rate for Payer: BCBS Trust/PPO |
$278.41
|
Rate for Payer: BCN Commercial |
$1,171.85
|
Rate for Payer: BCN Medicare Advantage |
$786.59
|
Rate for Payer: Cash Price |
$1,291.20
|
Rate for Payer: Cash Price |
$1,291.20
|
Rate for Payer: Cofinity Commercial |
$1,054.03
|
Rate for Payer: Cofinity Commercial |
$1,132.69
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$786.59
|
Rate for Payer: Mclaren Medicaid |
$515.03
|
Rate for Payer: Meridian Medicaid |
$540.78
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$825.92
|
Rate for Payer: PACE SWMI |
$786.59
|
Rate for Payer: PHP Medicare Advantage |
$786.59
|
Rate for Payer: Priority Health Choice Medicaid |
$515.03
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,129.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.55
|
Rate for Payer: Priority Health Medicare |
$786.59
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,224.55
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$786.59
|
Rate for Payer: UHC Dual Complete DSNP |
$786.59
|
Rate for Payer: UHC Medicare Advantage |
$810.19
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>
|
Professional
|
Both
|
$1,723.00
|
|
Service Code
|
HCPCS 21016
|
Min. Negotiated Rate |
$87.70 |
Max. Negotiated Rate |
$1,541.15 |
Rate for Payer: Aetna Commercial |
$1,331.34
|
Rate for Payer: Aetna Medicare |
$1,033.28
|
Rate for Payer: BCBS Complete |
$677.66
|
Rate for Payer: BCBS MAPPO |
$993.54
|
Rate for Payer: BCBS Trust/PPO |
$87.70
|
Rate for Payer: BCN Commercial |
$1,474.83
|
Rate for Payer: BCN Medicare Advantage |
$993.54
|
Rate for Payer: Cash Price |
$1,378.40
|
Rate for Payer: Cash Price |
$1,378.40
|
Rate for Payer: Cofinity Commercial |
$1,430.70
|
Rate for Payer: Cofinity Commercial |
$1,331.34
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.54
|
Rate for Payer: Mclaren Medicaid |
$645.39
|
Rate for Payer: Meridian Medicaid |
$677.66
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,043.22
|
Rate for Payer: PACE SWMI |
$993.54
|
Rate for Payer: PHP Medicare Advantage |
$993.54
|
Rate for Payer: Priority Health Choice Medicaid |
$645.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,206.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,541.15
|
Rate for Payer: Priority Health Medicare |
$993.54
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,541.15
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$993.54
|
Rate for Payer: UHC Dual Complete DSNP |
$993.54
|
Rate for Payer: UHC Medicare Advantage |
$1,023.35
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM
|
Professional
|
Both
|
$878.00
|
|
Service Code
|
HCPCS 21015
|
Min. Negotiated Rate |
$448.15 |
Max. Negotiated Rate |
$6,178.65 |
Rate for Payer: Aetna Commercial |
$918.72
|
Rate for Payer: Aetna Medicare |
$713.03
|
Rate for Payer: BCBS Complete |
$470.56
|
Rate for Payer: BCBS MAPPO |
$685.61
|
Rate for Payer: BCBS Trust/PPO |
$6,178.65
|
Rate for Payer: BCN Commercial |
$1,023.29
|
Rate for Payer: BCN Medicare Advantage |
$685.61
|
Rate for Payer: Cash Price |
$702.40
|
Rate for Payer: Cash Price |
$702.40
|
Rate for Payer: Cofinity Commercial |
$918.72
|
Rate for Payer: Cofinity Commercial |
$987.28
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.61
|
Rate for Payer: Mclaren Medicaid |
$448.15
|
Rate for Payer: Meridian Medicaid |
$470.56
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$719.89
|
Rate for Payer: PACE SWMI |
$685.61
|
Rate for Payer: PHP Medicare Advantage |
$685.61
|
Rate for Payer: Priority Health Choice Medicaid |
$448.15
|
Rate for Payer: Priority Health Cigna Priority Health |
$614.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,069.30
|
Rate for Payer: Priority Health Medicare |
$685.61
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.30
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$685.61
|
Rate for Payer: UHC Dual Complete DSNP |
$685.61
|
Rate for Payer: UHC Medicare Advantage |
$706.18
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$2,373.00
|
|
Service Code
|
HCPCS 22905
|
Min. Negotiated Rate |
$149.00 |
Max. Negotiated Rate |
$2,023.19 |
Rate for Payer: Aetna Commercial |
$1,762.38
|
Rate for Payer: Aetna Medicare |
$1,367.82
|
Rate for Payer: BCBS Complete |
$893.71
|
Rate for Payer: BCBS MAPPO |
$1,315.21
|
Rate for Payer: BCBS Trust/PPO |
$149.00
|
Rate for Payer: BCN Commercial |
$1,936.14
|
Rate for Payer: BCN Medicare Advantage |
$1,315.21
|
Rate for Payer: Cash Price |
$1,898.40
|
Rate for Payer: Cash Price |
$1,898.40
|
Rate for Payer: Cofinity Commercial |
$1,893.90
|
Rate for Payer: Cofinity Commercial |
$1,762.38
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,315.21
|
Rate for Payer: Mclaren Medicaid |
$851.15
|
Rate for Payer: Meridian Medicaid |
$893.71
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,380.97
|
Rate for Payer: PACE SWMI |
$1,315.21
|
Rate for Payer: PHP Medicare Advantage |
$1,315.21
|
Rate for Payer: Priority Health Choice Medicaid |
$851.15
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,661.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,023.19
|
Rate for Payer: Priority Health Medicare |
$1,315.21
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,023.19
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,315.21
|
Rate for Payer: UHC Dual Complete DSNP |
$1,315.21
|
Rate for Payer: UHC Medicare Advantage |
$1,354.67
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM
|
Professional
|
Both
|
$2,092.00
|
|
Service Code
|
HCPCS 22904
|
Min. Negotiated Rate |
$288.98 |
Max. Negotiated Rate |
$1,602.93 |
Rate for Payer: Aetna Commercial |
$1,394.30
|
Rate for Payer: Aetna Medicare |
$1,082.14
|
Rate for Payer: BCBS Complete |
$705.62
|
Rate for Payer: BCBS MAPPO |
$1,040.52
|
Rate for Payer: BCBS Trust/PPO |
$288.98
|
Rate for Payer: BCN Commercial |
$1,533.96
|
Rate for Payer: BCN Medicare Advantage |
$1,040.52
|
Rate for Payer: Cash Price |
$1,673.60
|
Rate for Payer: Cash Price |
$1,673.60
|
Rate for Payer: Cofinity Commercial |
$1,498.35
|
Rate for Payer: Cofinity Commercial |
$1,394.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.52
|
Rate for Payer: Mclaren Medicaid |
$672.02
|
Rate for Payer: Meridian Medicaid |
$705.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,092.55
|
Rate for Payer: PACE SWMI |
$1,040.52
|
Rate for Payer: PHP Medicare Advantage |
$1,040.52
|
Rate for Payer: Priority Health Choice Medicaid |
$672.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,464.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,602.93
|
Rate for Payer: Priority Health Medicare |
$1,040.52
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,602.93
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.52
|
Rate for Payer: UHC Dual Complete DSNP |
$1,040.52
|
Rate for Payer: UHC Medicare Advantage |
$1,071.74
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM
|
Professional
|
Both
|
$2,882.00
|
|
Service Code
|
HCPCS 21935
|
Min. Negotiated Rate |
$124.38 |
Max. Negotiated Rate |
$2,017.40 |
Rate for Payer: Aetna Commercial |
$1,352.81
|
Rate for Payer: Aetna Medicare |
$1,049.94
|
Rate for Payer: BCBS Complete |
$688.39
|
Rate for Payer: BCBS MAPPO |
$1,009.56
|
Rate for Payer: BCBS Trust/PPO |
$124.38
|
Rate for Payer: BCN Commercial |
$1,491.44
|
Rate for Payer: BCN Medicare Advantage |
$1,009.56
|
Rate for Payer: Cash Price |
$2,305.60
|
Rate for Payer: Cash Price |
$2,305.60
|
Rate for Payer: Cofinity Commercial |
$1,453.77
|
Rate for Payer: Cofinity Commercial |
$1,352.81
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,009.56
|
Rate for Payer: Mclaren Medicaid |
$655.61
|
Rate for Payer: Meridian Medicaid |
$688.39
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,060.04
|
Rate for Payer: PACE SWMI |
$1,009.56
|
Rate for Payer: PHP Medicare Advantage |
$1,009.56
|
Rate for Payer: Priority Health Choice Medicaid |
$655.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,017.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,558.51
|
Rate for Payer: Priority Health Medicare |
$1,009.56
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,558.51
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.56
|
Rate for Payer: UHC Dual Complete DSNP |
$1,009.56
|
Rate for Payer: UHC Medicare Advantage |
$1,039.85
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>
|
Professional
|
Both
|
$2,547.00
|
|
Service Code
|
HCPCS 21936
|
Min. Negotiated Rate |
$38.98 |
Max. Negotiated Rate |
$2,156.99 |
Rate for Payer: Aetna Commercial |
$1,877.76
|
Rate for Payer: Aetna Medicare |
$1,457.36
|
Rate for Payer: BCBS Complete |
$951.40
|
Rate for Payer: BCBS MAPPO |
$1,401.31
|
Rate for Payer: BCBS Trust/PPO |
$38.98
|
Rate for Payer: BCN Commercial |
$2,064.17
|
Rate for Payer: BCN Medicare Advantage |
$1,401.31
|
Rate for Payer: Cash Price |
$2,037.60
|
Rate for Payer: Cash Price |
$2,037.60
|
Rate for Payer: Cofinity Commercial |
$1,877.76
|
Rate for Payer: Cofinity Commercial |
$2,017.89
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,401.31
|
Rate for Payer: Mclaren Medicaid |
$906.10
|
Rate for Payer: Meridian Medicaid |
$951.40
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,471.38
|
Rate for Payer: PACE SWMI |
$1,401.31
|
Rate for Payer: PHP Medicare Advantage |
$1,401.31
|
Rate for Payer: Priority Health Choice Medicaid |
$906.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,782.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,156.99
|
Rate for Payer: Priority Health Medicare |
$1,401.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,401.31
|
Rate for Payer: UHC Dual Complete DSNP |
$1,401.31
|
Rate for Payer: UHC Medicare Advantage |
$1,443.35
|
|
PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>
|
Professional
|
Both
|
$2,268.00
|
|
Service Code
|
HCPCS 27616
|
Min. Negotiated Rate |
$807.06 |
Max. Negotiated Rate |
$1,936.38 |
Rate for Payer: Aetna Commercial |
$1,679.45
|
Rate for Payer: Aetna Medicare |
$1,303.45
|
Rate for Payer: BCBS Complete |
$847.41
|
Rate for Payer: BCBS MAPPO |
$1,253.32
|
Rate for Payer: BCBS Trust/PPO |
$928.75
|
Rate for Payer: BCN Commercial |
$1,853.06
|
Rate for Payer: BCN Medicare Advantage |
$1,253.32
|
Rate for Payer: Cash Price |
$1,814.40
|
Rate for Payer: Cash Price |
$1,814.40
|
Rate for Payer: Cofinity Commercial |
$1,804.78
|
Rate for Payer: Cofinity Commercial |
$1,679.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,253.32
|
Rate for Payer: Mclaren Medicaid |
$807.06
|
Rate for Payer: Meridian Medicaid |
$847.41
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,315.99
|
Rate for Payer: PACE SWMI |
$1,253.32
|
Rate for Payer: PHP Medicare Advantage |
$1,253.32
|
Rate for Payer: Priority Health Choice Medicaid |
$807.06
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,587.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,936.38
|
Rate for Payer: Priority Health Medicare |
$1,253.32
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,936.38
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,253.32
|
Rate for Payer: UHC Dual Complete DSNP |
$1,253.32
|
Rate for Payer: UHC Medicare Advantage |
$1,290.92
|
|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM
|
Professional
|
Both
|
$2,011.00
|
|
Service Code
|
HCPCS 23077
|
Min. Negotiated Rate |
$240.38 |
Max. Negotiated Rate |
$1,724.46 |
Rate for Payer: Aetna Commercial |
$1,499.45
|
Rate for Payer: Aetna Medicare |
$1,163.75
|
Rate for Payer: BCBS Complete |
$761.53
|
Rate for Payer: BCBS MAPPO |
$1,118.99
|
Rate for Payer: BCBS Trust/PPO |
$240.38
|
Rate for Payer: BCN Commercial |
$1,650.26
|
Rate for Payer: BCN Medicare Advantage |
$1,118.99
|
Rate for Payer: Cash Price |
$1,608.80
|
Rate for Payer: Cash Price |
$1,608.80
|
Rate for Payer: Cofinity Commercial |
$1,499.45
|
Rate for Payer: Cofinity Commercial |
$1,611.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,118.99
|
Rate for Payer: Mclaren Medicaid |
$725.27
|
Rate for Payer: Meridian Medicaid |
$761.53
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,174.94
|
Rate for Payer: PACE SWMI |
$1,118.99
|
Rate for Payer: PHP Medicare Advantage |
$1,118.99
|
Rate for Payer: Priority Health Choice Medicaid |
$725.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,407.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,724.46
|
Rate for Payer: Priority Health Medicare |
$1,118.99
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,724.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,118.99
|
Rate for Payer: UHC Dual Complete DSNP |
$1,118.99
|
Rate for Payer: UHC Medicare Advantage |
$1,152.56
|
|
PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>
|
Professional
|
Both
|
$6,526.00
|
|
Service Code
|
HCPCS 27364
|
Min. Negotiated Rate |
$1,000.46 |
Max. Negotiated Rate |
$4,568.20 |
Rate for Payer: Aetna Commercial |
$2,071.85
|
Rate for Payer: Aetna Medicare |
$1,608.01
|
Rate for Payer: BCBS Complete |
$1,050.48
|
Rate for Payer: BCBS MAPPO |
$1,546.16
|
Rate for Payer: BCBS Trust/PPO |
$2,166.03
|
Rate for Payer: BCN Commercial |
$2,283.59
|
Rate for Payer: BCN Medicare Advantage |
$1,546.16
|
Rate for Payer: Cash Price |
$5,220.80
|
Rate for Payer: Cash Price |
$5,220.80
|
Rate for Payer: Cofinity Commercial |
$2,226.47
|
Rate for Payer: Cofinity Commercial |
$2,071.85
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.16
|
Rate for Payer: Mclaren Medicaid |
$1,000.46
|
Rate for Payer: Meridian Medicaid |
$1,050.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,623.47
|
Rate for Payer: PACE SWMI |
$1,546.16
|
Rate for Payer: PHP Medicare Advantage |
$1,546.16
|
Rate for Payer: Priority Health Choice Medicaid |
$1,000.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,568.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,386.27
|
Rate for Payer: Priority Health Medicare |
$1,546.16
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,386.27
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.16
|
Rate for Payer: UHC Dual Complete DSNP |
$1,546.16
|
Rate for Payer: UHC Medicare Advantage |
$1,592.54
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
OP
|
$2,820.00
|
|
Service Code
|
CPT 25077
|
Hospital Charge Code |
25077
|
Min. Negotiated Rate |
$669.75 |
Max. Negotiated Rate |
$2,538.00 |
Rate for Payer: Aetna Commercial |
$2,397.00
|
Rate for Payer: Aetna Medicare |
$733.20
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.25
|
Rate for Payer: Amish Plain Church Group Commercial |
$881.25
|
Rate for Payer: BCBS Complete |
$1,957.20
|
Rate for Payer: BCBS MAPPO |
$705.00
|
Rate for Payer: BCBS Trust/PPO |
$2,192.55
|
Rate for Payer: BCN Commercial |
$2,192.55
|
Rate for Payer: BCN Medicare Advantage |
$705.00
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cofinity Commercial |
$2,425.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,256.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.00
|
Rate for Payer: Healthscope Commercial |
$2,538.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,115.00
|
Rate for Payer: Mclaren Medicaid |
$1,864.00
|
Rate for Payer: Meridian Medicaid |
$1,957.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$740.25
|
Rate for Payer: MI Amish Medical Board Commercial |
$810.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,397.00
|
Rate for Payer: PACE Senior Care Partners |
$669.75
|
Rate for Payer: PACE SWMI |
$705.00
|
Rate for Payer: PHP Commercial |
$2,397.00
|
Rate for Payer: PHP Medicare Advantage |
$705.00
|
Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,453.40
|
Rate for Payer: Priority Health Medicare |
$705.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,719.92
|
Rate for Payer: Railroad Medicare Medicare |
$705.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,481.60
|
Rate for Payer: UHC Core |
$2,354.70
|
Rate for Payer: UHC Dual Complete DSNP |
$705.00
|
Rate for Payer: UHC Medicare Advantage |
$726.15
|
Rate for Payer: VA VA |
$705.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,115.00
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,820.00
|
|
Service Code
|
HCPCS 25077
|
Hospital Charge Code |
25077
|
Min. Negotiated Rate |
$256.75 |
Max. Negotiated Rate |
$1,974.00 |
Rate for Payer: Aetna Commercial |
$1,173.12
|
Rate for Payer: Aetna Medicare |
$910.48
|
Rate for Payer: BCBS Complete |
$580.60
|
Rate for Payer: BCBS MAPPO |
$875.46
|
Rate for Payer: BCBS Trust/PPO |
$256.75
|
Rate for Payer: BCN Commercial |
$1,300.37
|
Rate for Payer: BCN Medicare Advantage |
$875.46
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cofinity Commercial |
$1,260.66
|
Rate for Payer: Cofinity Commercial |
$1,173.12
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.46
|
Rate for Payer: Mclaren Medicaid |
$552.95
|
Rate for Payer: Meridian Medicaid |
$580.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.23
|
Rate for Payer: PACE SWMI |
$875.46
|
Rate for Payer: PHP Medicare Advantage |
$875.46
|
Rate for Payer: Priority Health Choice Medicaid |
$552.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,358.84
|
Rate for Payer: Priority Health Medicare |
$875.46
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,358.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$875.46
|
Rate for Payer: UHC Dual Complete DSNP |
$875.46
|
Rate for Payer: UHC Medicare Advantage |
$901.72
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
IP
|
$2,820.00
|
|
Service Code
|
CPT 25077
|
Hospital Charge Code |
25077
|
Min. Negotiated Rate |
$1,719.92 |
Max. Negotiated Rate |
$2,538.00 |
Rate for Payer: Aetna Commercial |
$2,397.00
|
Rate for Payer: BCBS Trust/PPO |
$2,179.30
|
Rate for Payer: BCN Commercial |
$2,179.30
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cofinity Commercial |
$2,425.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,256.00
|
Rate for Payer: Healthscope Commercial |
$2,538.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,115.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,397.00
|
Rate for Payer: PHP Commercial |
$2,397.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,453.40
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,719.92
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,481.60
|
Rate for Payer: UHC Core |
$2,354.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,115.00
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,820.00
|
|
Service Code
|
HCPCS 25077
|
Min. Negotiated Rate |
$256.75 |
Max. Negotiated Rate |
$1,974.00 |
Rate for Payer: Aetna Commercial |
$1,173.12
|
Rate for Payer: Aetna Medicare |
$910.48
|
Rate for Payer: BCBS Complete |
$580.60
|
Rate for Payer: BCBS MAPPO |
$875.46
|
Rate for Payer: BCBS Trust/PPO |
$256.75
|
Rate for Payer: BCN Commercial |
$1,300.37
|
Rate for Payer: BCN Medicare Advantage |
$875.46
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cash Price |
$2,256.00
|
Rate for Payer: Cofinity Commercial |
$1,260.66
|
Rate for Payer: Cofinity Commercial |
$1,173.12
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.46
|
Rate for Payer: Mclaren Medicaid |
$552.95
|
Rate for Payer: Meridian Medicaid |
$580.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.23
|
Rate for Payer: PACE SWMI |
$875.46
|
Rate for Payer: PHP Medicare Advantage |
$875.46
|
Rate for Payer: Priority Health Choice Medicaid |
$552.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,974.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,358.84
|
Rate for Payer: Priority Health Medicare |
$875.46
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,358.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$875.46
|
Rate for Payer: UHC Dual Complete DSNP |
$875.46
|
Rate for Payer: UHC Medicare Advantage |
$901.72
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM
|
Professional
|
Both
|
$1,644.00
|
|
Service Code
|
HCPCS 21557
|
Min. Negotiated Rate |
$57.48 |
Max. Negotiated Rate |
$1,459.44 |
Rate for Payer: Aetna Commercial |
$1,264.83
|
Rate for Payer: Aetna Medicare |
$981.66
|
Rate for Payer: BCBS Complete |
$645.90
|
Rate for Payer: BCBS MAPPO |
$943.90
|
Rate for Payer: BCBS Trust/PPO |
$57.48
|
Rate for Payer: BCN Commercial |
$1,396.64
|
Rate for Payer: BCN Medicare Advantage |
$943.90
|
Rate for Payer: Cash Price |
$1,315.20
|
Rate for Payer: Cash Price |
$1,315.20
|
Rate for Payer: Cofinity Commercial |
$1,359.22
|
Rate for Payer: Cofinity Commercial |
$1,264.83
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.90
|
Rate for Payer: Mclaren Medicaid |
$615.14
|
Rate for Payer: Meridian Medicaid |
$645.90
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$991.10
|
Rate for Payer: PACE SWMI |
$943.90
|
Rate for Payer: PHP Medicare Advantage |
$943.90
|
Rate for Payer: Priority Health Choice Medicaid |
$615.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,150.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,459.44
|
Rate for Payer: Priority Health Medicare |
$943.90
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,459.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$943.90
|
Rate for Payer: UHC Dual Complete DSNP |
$943.90
|
Rate for Payer: UHC Medicare Advantage |
$972.22
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>
|
Professional
|
Both
|
$3,351.00
|
|
Service Code
|
HCPCS 21558
|
Min. Negotiated Rate |
$57.48 |
Max. Negotiated Rate |
$2,345.70 |
Rate for Payer: Aetna Commercial |
$1,782.92
|
Rate for Payer: Aetna Medicare |
$1,383.76
|
Rate for Payer: BCBS Complete |
$900.20
|
Rate for Payer: BCBS MAPPO |
$1,330.54
|
Rate for Payer: BCBS Trust/PPO |
$57.48
|
Rate for Payer: BCN Commercial |
$1,962.53
|
Rate for Payer: BCN Medicare Advantage |
$1,330.54
|
Rate for Payer: Cash Price |
$2,680.80
|
Rate for Payer: Cash Price |
$2,680.80
|
Rate for Payer: Cofinity Commercial |
$1,915.98
|
Rate for Payer: Cofinity Commercial |
$1,782.92
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,330.54
|
Rate for Payer: Mclaren Medicaid |
$857.33
|
Rate for Payer: Meridian Medicaid |
$900.20
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,397.07
|
Rate for Payer: PACE SWMI |
$1,330.54
|
Rate for Payer: PHP Medicare Advantage |
$1,330.54
|
Rate for Payer: Priority Health Choice Medicaid |
$857.33
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,345.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,050.77
|
Rate for Payer: Priority Health Medicare |
$1,330.54
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,050.77
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,330.54
|
Rate for Payer: UHC Dual Complete DSNP |
$1,330.54
|
Rate for Payer: UHC Medicare Advantage |
$1,370.46
|
|