|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,221.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$215.26 |
| Max. Negotiated Rate |
$1,098.90 |
| Rate for Payer: Aetna Commercial |
$1,037.85
|
| Rate for Payer: Aetna Medicare |
$317.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.56
|
| Rate for Payer: BCBS Complete |
$226.01
|
| Rate for Payer: BCBS MAPPO |
$305.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.78
|
| Rate for Payer: BCN Commercial |
$1,003.78
|
| Rate for Payer: BCN Medicare Advantage |
$305.25
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cofinity Commercial |
$1,050.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.25
|
| Rate for Payer: Healthscope Commercial |
$1,098.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$915.75
|
| Rate for Payer: Mclaren Medicaid |
$215.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.51
|
| Rate for Payer: Meridian Medicaid |
$226.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.85
|
| Rate for Payer: Nomi Health Commercial |
$1,001.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: PACE Senior Care Partners |
$289.99
|
| Rate for Payer: PACE SWMI |
$305.25
|
| Rate for Payer: PHP Commercial |
$1,037.85
|
| Rate for Payer: PHP Medicare Advantage |
$305.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,062.27
|
| Rate for Payer: Priority Health Medicare |
$308.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.82
|
| Rate for Payer: Railroad Medicare Medicare |
$305.25
|
| Rate for Payer: UHC Core |
$1,019.53
|
| Rate for Payer: UHC Exchange |
$305.25
|
| Rate for Payer: UHC Medicaid |
$215.26
|
| Rate for Payer: UHC Medicare Advantage |
$305.25
|
| Rate for Payer: UHCCP Medicaid |
$215.26
|
| Rate for Payer: VA VA |
$305.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$915.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$446.45 |
| Max. Negotiated Rate |
$1,194.55 |
| Rate for Payer: Aetna Commercial |
$990.70
|
| Rate for Payer: Aetna Medicare |
$610.50
|
| Rate for Payer: BCBS Complete |
$468.77
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Mclaren Medicaid |
$446.45
|
| Rate for Payer: Meridian Medicaid |
$468.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,194.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,194.55
|
| Rate for Payer: UHC Medicaid |
$446.45
|
| Rate for Payer: UHCCP Medicaid |
$446.45
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,221.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$446.45 |
| Max. Negotiated Rate |
$1,194.55 |
| Rate for Payer: Aetna Commercial |
$990.70
|
| Rate for Payer: Aetna Medicare |
$610.50
|
| Rate for Payer: BCBS Complete |
$468.77
|
| Rate for Payer: BCN Commercial |
$1,117.47
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Cash Price |
$976.80
|
| Rate for Payer: Mclaren Medicaid |
$446.45
|
| Rate for Payer: Meridian Medicaid |
$468.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,194.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,194.55
|
| Rate for Payer: UHC Medicaid |
$446.45
|
| Rate for Payer: UHCCP Medicaid |
$446.45
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,075.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$400.01 |
| Max. Negotiated Rate |
$1,556.25 |
| Rate for Payer: Aetna Commercial |
$887.07
|
| Rate for Payer: Aetna Medicare |
$1,037.50
|
| Rate for Payer: BCBS Complete |
$420.01
|
| Rate for Payer: BCN Commercial |
$1,009.41
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Cash Price |
$1,660.00
|
| Rate for Payer: Mclaren Medicaid |
$400.01
|
| Rate for Payer: Meridian Medicaid |
$420.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,079.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,079.02
|
| Rate for Payer: UHC Medicaid |
$400.01
|
| Rate for Payer: UHCCP Medicaid |
$400.01
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$909.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$306.29 |
| Max. Negotiated Rate |
$845.88 |
| Rate for Payer: Aetna Commercial |
$692.90
|
| Rate for Payer: Aetna Medicare |
$454.50
|
| Rate for Payer: BCBS Complete |
$321.60
|
| Rate for Payer: BCN Commercial |
$791.29
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Cash Price |
$727.20
|
| Rate for Payer: Mclaren Medicaid |
$306.29
|
| Rate for Payer: Meridian Medicaid |
$321.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$306.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$845.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$845.88
|
| Rate for Payer: UHC Medicaid |
$306.29
|
| Rate for Payer: UHCCP Medicaid |
$306.29
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$721.50 |
| Rate for Payer: Aetna Commercial |
$530.82
|
| Rate for Payer: Aetna Medicare |
$481.00
|
| Rate for Payer: BCBS Complete |
$248.92
|
| Rate for Payer: BCN Commercial |
$609.03
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Mclaren Medicaid |
$237.07
|
| Rate for Payer: Meridian Medicaid |
$248.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$651.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$651.04
|
| Rate for Payer: UHC Medicaid |
$237.07
|
| Rate for Payer: UHCCP Medicaid |
$237.07
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,659.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$257.94 |
| Max. Negotiated Rate |
$1,244.25 |
| Rate for Payer: Aetna Commercial |
$565.63
|
| Rate for Payer: Aetna Medicare |
$829.50
|
| Rate for Payer: BCBS Complete |
$270.84
|
| Rate for Payer: BCN Commercial |
$648.38
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Cash Price |
$1,327.20
|
| Rate for Payer: Mclaren Medicaid |
$257.94
|
| Rate for Payer: Meridian Medicaid |
$270.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,244.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$693.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$693.09
|
| Rate for Payer: UHC Medicaid |
$257.94
|
| Rate for Payer: UHCCP Medicaid |
$257.94
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$313.11 |
| Max. Negotiated Rate |
$1,392.00 |
| Rate for Payer: Aetna Commercial |
$687.12
|
| Rate for Payer: Aetna Medicare |
$928.00
|
| Rate for Payer: BCBS Complete |
$328.77
|
| Rate for Payer: BCN Commercial |
$797.27
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Mclaren Medicaid |
$313.11
|
| Rate for Payer: Meridian Medicaid |
$328.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,392.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$852.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$852.26
|
| Rate for Payer: UHC Medicaid |
$313.11
|
| Rate for Payer: UHCCP Medicaid |
$313.11
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$313.32 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$705.78
|
| Rate for Payer: Aetna Medicare |
$893.00
|
| Rate for Payer: BCBS Complete |
$328.99
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Mclaren Medicaid |
$313.32
|
| Rate for Payer: Meridian Medicaid |
$328.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$858.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.65
|
| Rate for Payer: UHC Medicaid |
$313.32
|
| Rate for Payer: UHCCP Medicaid |
$313.32
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,786.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$314.87 |
| Max. Negotiated Rate |
$1,607.40 |
| Rate for Payer: Aetna Commercial |
$1,518.10
|
| Rate for Payer: Aetna Medicare |
$464.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$558.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$558.12
|
| Rate for Payer: BCBS Complete |
$330.59
|
| Rate for Payer: BCBS MAPPO |
$446.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.27
|
| Rate for Payer: BCN Commercial |
$1,468.27
|
| Rate for Payer: BCN Medicare Advantage |
$446.50
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,535.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,428.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.50
|
| Rate for Payer: Healthscope Commercial |
$1,607.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,339.50
|
| Rate for Payer: Mclaren Medicaid |
$314.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$468.82
|
| Rate for Payer: Meridian Medicaid |
$330.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$513.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,518.10
|
| Rate for Payer: Nomi Health Commercial |
$1,464.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE Senior Care Partners |
$424.18
|
| Rate for Payer: PACE SWMI |
$446.50
|
| Rate for Payer: PHP Commercial |
$1,518.10
|
| Rate for Payer: PHP Medicare Advantage |
$446.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,553.82
|
| Rate for Payer: Priority Health Medicare |
$450.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,243.06
|
| Rate for Payer: Railroad Medicare Medicare |
$446.50
|
| Rate for Payer: UHC Core |
$1,491.31
|
| Rate for Payer: UHC Exchange |
$446.50
|
| Rate for Payer: UHC Medicaid |
$314.87
|
| Rate for Payer: UHC Medicare Advantage |
$446.50
|
| Rate for Payer: UHCCP Medicaid |
$314.87
|
| Rate for Payer: VA VA |
$446.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,339.50
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$313.32 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$705.78
|
| Rate for Payer: Aetna Medicare |
$893.00
|
| Rate for Payer: BCBS Complete |
$328.99
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Mclaren Medicaid |
$313.32
|
| Rate for Payer: Meridian Medicaid |
$328.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$858.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.65
|
| Rate for Payer: UHC Medicaid |
$313.32
|
| Rate for Payer: UHCCP Medicaid |
$313.32
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,786.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,243.06 |
| Max. Negotiated Rate |
$1,607.40 |
| Rate for Payer: Aetna Commercial |
$1,518.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,475.06
|
| Rate for Payer: BCN Commercial |
$1,475.06
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,535.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,428.80
|
| Rate for Payer: Healthscope Commercial |
$1,607.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,339.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,518.10
|
| Rate for Payer: Nomi Health Commercial |
$1,464.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PHP Commercial |
$1,518.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,553.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,243.06
|
| Rate for Payer: UHC Core |
$1,491.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,339.50
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$890.05 |
| Rate for Payer: Aetna Commercial |
$722.71
|
| Rate for Payer: Aetna Medicare |
$526.50
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCN Commercial |
$832.63
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Mclaren Medicaid |
$333.77
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$890.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$890.05
|
| Rate for Payer: UHC Medicaid |
$333.77
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,053.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$185.64 |
| Max. Negotiated Rate |
$947.70 |
| Rate for Payer: Aetna Commercial |
$895.05
|
| Rate for Payer: Aetna Medicare |
$273.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.06
|
| Rate for Payer: BCBS Complete |
$194.91
|
| Rate for Payer: BCBS MAPPO |
$263.25
|
| Rate for Payer: BCBS Trust/PPO |
$865.67
|
| Rate for Payer: BCN Commercial |
$865.67
|
| Rate for Payer: BCN Medicare Advantage |
$263.25
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$905.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.25
|
| Rate for Payer: Healthscope Commercial |
$947.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.75
|
| Rate for Payer: Mclaren Medicaid |
$185.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.41
|
| Rate for Payer: Meridian Medicaid |
$194.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$289.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$863.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: PACE Senior Care Partners |
$250.09
|
| Rate for Payer: PACE SWMI |
$263.25
|
| Rate for Payer: PHP Commercial |
$895.05
|
| Rate for Payer: PHP Medicare Advantage |
$263.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$916.11
|
| Rate for Payer: Priority Health Medicare |
$265.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.89
|
| Rate for Payer: Railroad Medicare Medicare |
$263.25
|
| Rate for Payer: UHC Core |
$879.25
|
| Rate for Payer: UHC Exchange |
$263.25
|
| Rate for Payer: UHC Medicaid |
$185.64
|
| Rate for Payer: UHC Medicare Advantage |
$263.25
|
| Rate for Payer: UHCCP Medicaid |
$185.64
|
| Rate for Payer: VA VA |
$263.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.75
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$890.05 |
| Rate for Payer: Aetna Commercial |
$722.71
|
| Rate for Payer: Aetna Medicare |
$526.50
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCN Commercial |
$832.63
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Mclaren Medicaid |
$333.77
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$890.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$890.05
|
| Rate for Payer: UHC Medicaid |
$333.77
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,053.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$732.89 |
| Max. Negotiated Rate |
$947.70 |
| Rate for Payer: Aetna Commercial |
$895.05
|
| Rate for Payer: BCBS Trust/PPO |
$869.67
|
| Rate for Payer: BCN Commercial |
$869.67
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$905.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Healthscope Commercial |
$947.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$863.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: PHP Commercial |
$895.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$916.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.89
|
| Rate for Payer: UHC Core |
$879.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.75
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,196.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$349.11 |
| Max. Negotiated Rate |
$920.92 |
| Rate for Payer: Aetna Commercial |
$757.16
|
| Rate for Payer: Aetna Medicare |
$598.00
|
| Rate for Payer: BCBS Complete |
$366.57
|
| Rate for Payer: BCN Commercial |
$861.51
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Mclaren Medicaid |
$349.11
|
| Rate for Payer: Meridian Medicaid |
$366.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$920.92
|
| Rate for Payer: UHC Medicaid |
$349.11
|
| Rate for Payer: UHCCP Medicaid |
$349.11
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,196.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$210.85 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna Commercial |
$1,016.60
|
| Rate for Payer: Aetna Medicare |
$310.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$373.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$373.75
|
| Rate for Payer: BCBS Complete |
$221.38
|
| Rate for Payer: BCBS MAPPO |
$299.00
|
| Rate for Payer: BCBS Trust/PPO |
$983.23
|
| Rate for Payer: BCN Commercial |
$983.23
|
| Rate for Payer: BCN Medicare Advantage |
$299.00
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$1,028.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.00
|
| Rate for Payer: Healthscope Commercial |
$1,076.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$897.00
|
| Rate for Payer: Mclaren Medicaid |
$210.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.95
|
| Rate for Payer: Meridian Medicaid |
$221.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$328.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.60
|
| Rate for Payer: Nomi Health Commercial |
$980.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: PACE Senior Care Partners |
$284.05
|
| Rate for Payer: PACE SWMI |
$299.00
|
| Rate for Payer: PHP Commercial |
$1,016.60
|
| Rate for Payer: PHP Medicare Advantage |
$299.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,040.52
|
| Rate for Payer: Priority Health Medicare |
$301.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$832.42
|
| Rate for Payer: Railroad Medicare Medicare |
$299.00
|
| Rate for Payer: UHC Core |
$998.66
|
| Rate for Payer: UHC Exchange |
$299.00
|
| Rate for Payer: UHC Medicaid |
$210.85
|
| Rate for Payer: UHC Medicare Advantage |
$299.00
|
| Rate for Payer: UHCCP Medicaid |
$210.85
|
| Rate for Payer: VA VA |
$299.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.00
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,196.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$349.11 |
| Max. Negotiated Rate |
$920.92 |
| Rate for Payer: Aetna Commercial |
$757.16
|
| Rate for Payer: Aetna Medicare |
$598.00
|
| Rate for Payer: BCBS Complete |
$366.57
|
| Rate for Payer: BCN Commercial |
$861.51
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Mclaren Medicaid |
$349.11
|
| Rate for Payer: Meridian Medicaid |
$366.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$920.92
|
| Rate for Payer: UHC Medicaid |
$349.11
|
| Rate for Payer: UHCCP Medicaid |
$349.11
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,196.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$832.42 |
| Max. Negotiated Rate |
$1,076.40 |
| Rate for Payer: Aetna Commercial |
$1,016.60
|
| Rate for Payer: BCBS Trust/PPO |
$987.78
|
| Rate for Payer: BCN Commercial |
$987.78
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$1,028.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.80
|
| Rate for Payer: Healthscope Commercial |
$1,076.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$897.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.60
|
| Rate for Payer: Nomi Health Commercial |
$980.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: PHP Commercial |
$1,016.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,040.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$832.42
|
| Rate for Payer: UHC Core |
$998.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.00
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,081.16 |
| Rate for Payer: Aetna Commercial |
$895.18
|
| Rate for Payer: Aetna Medicare |
$619.50
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCN Commercial |
$1,011.40
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Mclaren Medicaid |
$409.17
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,081.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.16
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Facility
|
IP
|
$1,239.00
|
|
|
Service Code
|
CPT 22901
|
| Hospital Charge Code |
22901
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$862.34 |
| Max. Negotiated Rate |
$1,115.10 |
| Rate for Payer: Aetna Commercial |
$1,053.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.29
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$1,065.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.20
|
| Rate for Payer: Healthscope Commercial |
$1,115.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.15
|
| Rate for Payer: Nomi Health Commercial |
$1,015.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PHP Commercial |
$1,053.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,077.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.34
|
| Rate for Payer: UHC Core |
$1,034.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Facility
|
OP
|
$1,239.00
|
|
|
Service Code
|
CPT 22901
|
| Hospital Charge Code |
22901
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$218.44 |
| Max. Negotiated Rate |
$1,115.10 |
| Rate for Payer: Aetna Commercial |
$1,053.15
|
| Rate for Payer: Aetna Medicare |
$322.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$387.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$387.19
|
| Rate for Payer: BCBS Complete |
$229.34
|
| Rate for Payer: BCBS MAPPO |
$309.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.58
|
| Rate for Payer: BCN Commercial |
$1,018.58
|
| Rate for Payer: BCN Medicare Advantage |
$309.75
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$1,065.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.75
|
| Rate for Payer: Healthscope Commercial |
$1,115.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.25
|
| Rate for Payer: Mclaren Medicaid |
$218.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.24
|
| Rate for Payer: Meridian Medicaid |
$229.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.15
|
| Rate for Payer: Nomi Health Commercial |
$1,015.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PACE Senior Care Partners |
$294.26
|
| Rate for Payer: PACE SWMI |
$309.75
|
| Rate for Payer: PHP Commercial |
$1,053.15
|
| Rate for Payer: PHP Medicare Advantage |
$309.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,077.93
|
| Rate for Payer: Priority Health Medicare |
$312.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.34
|
| Rate for Payer: Railroad Medicare Medicare |
$309.75
|
| Rate for Payer: UHC Core |
$1,034.57
|
| Rate for Payer: UHC Exchange |
$309.75
|
| Rate for Payer: UHC Medicaid |
$218.44
|
| Rate for Payer: UHC Medicare Advantage |
$309.75
|
| Rate for Payer: UHCCP Medicaid |
$218.44
|
| Rate for Payer: VA VA |
$309.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 22901
|
| Hospital Charge Code |
22901
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,081.16 |
| Rate for Payer: Aetna Commercial |
$895.18
|
| Rate for Payer: Aetna Medicare |
$619.50
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCN Commercial |
$1,011.40
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Mclaren Medicaid |
$409.17
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,081.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.16
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$735.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$129.58 |
| Max. Negotiated Rate |
$661.50 |
| Rate for Payer: Aetna Commercial |
$624.75
|
| Rate for Payer: Aetna Medicare |
$191.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.69
|
| Rate for Payer: BCBS Complete |
$136.05
|
| Rate for Payer: BCBS MAPPO |
$183.75
|
| Rate for Payer: BCBS Trust/PPO |
$604.24
|
| Rate for Payer: BCN Commercial |
$604.24
|
| Rate for Payer: BCN Medicare Advantage |
$183.75
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$632.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.75
|
| Rate for Payer: Healthscope Commercial |
$661.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.25
|
| Rate for Payer: Mclaren Medicaid |
$129.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.94
|
| Rate for Payer: Meridian Medicaid |
$136.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.75
|
| Rate for Payer: Nomi Health Commercial |
$602.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE Senior Care Partners |
$174.56
|
| Rate for Payer: PACE SWMI |
$183.75
|
| Rate for Payer: PHP Commercial |
$624.75
|
| Rate for Payer: PHP Medicare Advantage |
$183.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$639.45
|
| Rate for Payer: Priority Health Medicare |
$185.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$511.56
|
| Rate for Payer: Railroad Medicare Medicare |
$183.75
|
| Rate for Payer: UHC Core |
$613.73
|
| Rate for Payer: UHC Exchange |
$183.75
|
| Rate for Payer: UHC Medicaid |
$129.58
|
| Rate for Payer: UHC Medicare Advantage |
$183.75
|
| Rate for Payer: UHCCP Medicaid |
$129.58
|
| Rate for Payer: VA VA |
$183.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.25
|
|
