|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,635.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,137.96 |
| Max. Negotiated Rate |
$1,471.50 |
| Rate for Payer: Aetna Commercial |
$1,389.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,350.35
|
| Rate for Payer: BCN Commercial |
$1,350.35
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$1,406.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.00
|
| Rate for Payer: Healthscope Commercial |
$1,471.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,226.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.75
|
| Rate for Payer: Nomi Health Commercial |
$1,340.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PHP Commercial |
$1,389.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,422.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,137.96
|
| Rate for Payer: UHC Core |
$1,365.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,226.25
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,635.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$420.04 |
| Max. Negotiated Rate |
$1,226.25 |
| Rate for Payer: Aetna Commercial |
$933.13
|
| Rate for Payer: Aetna Medicare |
$817.50
|
| Rate for Payer: BCBS Complete |
$441.04
|
| Rate for Payer: BCN Commercial |
$1,059.21
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Mclaren Medicaid |
$420.04
|
| Rate for Payer: Meridian Medicaid |
$441.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,132.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,132.26
|
| Rate for Payer: UHC Medicaid |
$420.04
|
| Rate for Payer: UHCCP Medicaid |
$420.04
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,635.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$288.25 |
| Max. Negotiated Rate |
$1,471.50 |
| Rate for Payer: Aetna Commercial |
$1,389.75
|
| Rate for Payer: Aetna Medicare |
$425.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$510.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$510.94
|
| Rate for Payer: BCBS Complete |
$302.64
|
| Rate for Payer: BCBS MAPPO |
$408.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,344.13
|
| Rate for Payer: BCN Commercial |
$1,344.13
|
| Rate for Payer: BCN Medicare Advantage |
$408.75
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$1,406.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.75
|
| Rate for Payer: Healthscope Commercial |
$1,471.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,226.25
|
| Rate for Payer: Mclaren Medicaid |
$288.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.19
|
| Rate for Payer: Meridian Medicaid |
$302.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$470.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.75
|
| Rate for Payer: Nomi Health Commercial |
$1,340.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PACE Senior Care Partners |
$388.31
|
| Rate for Payer: PACE SWMI |
$408.75
|
| Rate for Payer: PHP Commercial |
$1,389.75
|
| Rate for Payer: PHP Medicare Advantage |
$408.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,422.45
|
| Rate for Payer: Priority Health Medicare |
$412.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,137.96
|
| Rate for Payer: Railroad Medicare Medicare |
$408.75
|
| Rate for Payer: UHC Core |
$1,365.22
|
| Rate for Payer: UHC Exchange |
$408.75
|
| Rate for Payer: UHC Medicaid |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$408.75
|
| Rate for Payer: UHCCP Medicaid |
$288.25
|
| Rate for Payer: VA VA |
$408.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,226.25
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,374.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,530.50 |
| Rate for Payer: Aetna Commercial |
$1,008.38
|
| Rate for Payer: Aetna Medicare |
$1,687.00
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCN Commercial |
$1,146.36
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Mclaren Medicaid |
$455.61
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,530.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,225.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,225.42
|
| Rate for Payer: UHC Medicaid |
$455.61
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$832.30
|
| Rate for Payer: Aetna Medicare |
$900.00
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCN Commercial |
$948.65
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Mclaren Medicaid |
$376.37
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,014.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,014.08
|
| Rate for Payer: UHC Medicaid |
$376.37
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$542.43
|
| Rate for Payer: Aetna Medicare |
$802.00
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Mclaren Medicaid |
$249.85
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$661.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.69
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,604.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,116.38 |
| Max. Negotiated Rate |
$1,443.60 |
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.74
|
| Rate for Payer: BCN Commercial |
$1,324.74
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,203.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,363.40
|
| Rate for Payer: Nomi Health Commercial |
$1,315.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,395.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,116.38
|
| Rate for Payer: UHC Core |
$1,339.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,203.00
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,604.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$282.79 |
| Max. Negotiated Rate |
$1,443.60 |
| Rate for Payer: Aetna Commercial |
$1,363.40
|
| Rate for Payer: Aetna Medicare |
$417.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$501.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$501.25
|
| Rate for Payer: BCBS Complete |
$296.90
|
| Rate for Payer: BCBS MAPPO |
$401.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,318.65
|
| Rate for Payer: BCN Commercial |
$1,318.65
|
| Rate for Payer: BCN Medicare Advantage |
$401.00
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,379.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.00
|
| Rate for Payer: Healthscope Commercial |
$1,443.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,203.00
|
| Rate for Payer: Mclaren Medicaid |
$282.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.05
|
| Rate for Payer: Meridian Medicaid |
$296.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$441.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,363.40
|
| Rate for Payer: Nomi Health Commercial |
$1,315.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE Senior Care Partners |
$380.95
|
| Rate for Payer: PACE SWMI |
$401.00
|
| Rate for Payer: PHP Commercial |
$1,363.40
|
| Rate for Payer: PHP Medicare Advantage |
$401.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,395.48
|
| Rate for Payer: Priority Health Medicare |
$405.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,116.38
|
| Rate for Payer: Railroad Medicare Medicare |
$401.00
|
| Rate for Payer: UHC Core |
$1,339.34
|
| Rate for Payer: UHC Exchange |
$401.00
|
| Rate for Payer: UHC Medicaid |
$282.79
|
| Rate for Payer: UHC Medicare Advantage |
$401.00
|
| Rate for Payer: UHCCP Medicaid |
$282.79
|
| Rate for Payer: VA VA |
$401.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,203.00
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$542.43
|
| Rate for Payer: Aetna Medicare |
$802.00
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Mclaren Medicaid |
$249.85
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$661.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.69
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,336.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$929.86 |
| Max. Negotiated Rate |
$1,202.40 |
| Rate for Payer: Aetna Commercial |
$1,135.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,103.40
|
| Rate for Payer: BCN Commercial |
$1,103.40
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$1,148.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.80
|
| Rate for Payer: Healthscope Commercial |
$1,202.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,002.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,135.60
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PHP Commercial |
$1,135.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,162.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$929.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,175.68
|
| Rate for Payer: UHC Core |
$1,115.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,002.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$437.22
|
| Rate for Payer: Aetna Medicare |
$668.00
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCN Commercial |
$505.45
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$540.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.32
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$437.22
|
| Rate for Payer: Aetna Medicare |
$668.00
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCN Commercial |
$505.45
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Mclaren Medicaid |
$204.48
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$540.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.32
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,336.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$235.54 |
| Max. Negotiated Rate |
$1,202.40 |
| Rate for Payer: Aetna Commercial |
$1,135.60
|
| Rate for Payer: Aetna Medicare |
$347.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417.50
|
| Rate for Payer: BCBS Complete |
$247.29
|
| Rate for Payer: BCBS MAPPO |
$334.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,098.33
|
| Rate for Payer: BCN Commercial |
$1,098.33
|
| Rate for Payer: BCN Medicare Advantage |
$334.00
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$1,148.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.00
|
| Rate for Payer: Healthscope Commercial |
$1,202.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,002.00
|
| Rate for Payer: Mclaren Medicaid |
$235.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.70
|
| Rate for Payer: Meridian Medicaid |
$247.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$367.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,135.60
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE Senior Care Partners |
$317.30
|
| Rate for Payer: PACE SWMI |
$334.00
|
| Rate for Payer: PHP Commercial |
$1,135.60
|
| Rate for Payer: PHP Medicare Advantage |
$334.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,162.32
|
| Rate for Payer: Priority Health Medicare |
$337.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$929.86
|
| Rate for Payer: Railroad Medicare Medicare |
$334.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,175.68
|
| Rate for Payer: UHC Core |
$1,115.56
|
| Rate for Payer: UHC Exchange |
$334.00
|
| Rate for Payer: UHC Medicaid |
$235.54
|
| Rate for Payer: UHC Medicare Advantage |
$334.00
|
| Rate for Payer: UHCCP Medicaid |
$235.54
|
| Rate for Payer: VA VA |
$334.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,002.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,744.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,213.82 |
| Max. Negotiated Rate |
$1,569.60 |
| Rate for Payer: Aetna Commercial |
$1,482.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,440.37
|
| Rate for Payer: BCN Commercial |
$1,440.37
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,499.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,395.20
|
| Rate for Payer: Healthscope Commercial |
$1,569.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,308.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,482.40
|
| Rate for Payer: Nomi Health Commercial |
$1,430.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PHP Commercial |
$1,482.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,517.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,213.82
|
| Rate for Payer: UHC Core |
$1,456.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,308.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,744.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$307.47 |
| Max. Negotiated Rate |
$1,569.60 |
| Rate for Payer: Aetna Commercial |
$1,482.40
|
| Rate for Payer: Aetna Medicare |
$453.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.00
|
| Rate for Payer: BCBS Complete |
$322.81
|
| Rate for Payer: BCBS MAPPO |
$436.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,433.74
|
| Rate for Payer: BCN Commercial |
$1,433.74
|
| Rate for Payer: BCN Medicare Advantage |
$436.00
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,499.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,395.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.00
|
| Rate for Payer: Healthscope Commercial |
$1,569.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,308.00
|
| Rate for Payer: Mclaren Medicaid |
$307.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$457.80
|
| Rate for Payer: Meridian Medicaid |
$322.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$501.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$479.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,482.40
|
| Rate for Payer: Nomi Health Commercial |
$1,430.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PACE Senior Care Partners |
$414.20
|
| Rate for Payer: PACE SWMI |
$436.00
|
| Rate for Payer: PHP Commercial |
$1,482.40
|
| Rate for Payer: PHP Medicare Advantage |
$436.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,517.28
|
| Rate for Payer: Priority Health Medicare |
$440.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,213.82
|
| Rate for Payer: Railroad Medicare Medicare |
$436.00
|
| Rate for Payer: UHC Core |
$1,456.24
|
| Rate for Payer: UHC Exchange |
$436.00
|
| Rate for Payer: UHC Medicaid |
$307.47
|
| Rate for Payer: UHC Medicare Advantage |
$436.00
|
| Rate for Payer: UHCCP Medicaid |
$307.47
|
| Rate for Payer: VA VA |
$436.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,308.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$416.63 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$928.71
|
| Rate for Payer: Aetna Medicare |
$872.00
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCN Commercial |
$1,054.73
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Mclaren Medicaid |
$416.63
|
| Rate for Payer: Meridian Medicaid |
$437.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,127.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.47
|
| Rate for Payer: UHC Medicaid |
$416.63
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$416.63 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$928.71
|
| Rate for Payer: Aetna Medicare |
$872.00
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCN Commercial |
$1,054.73
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Mclaren Medicaid |
$416.63
|
| Rate for Payer: Meridian Medicaid |
$437.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,127.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.47
|
| Rate for Payer: UHC Medicaid |
$416.63
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$1,190.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$209.80 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$1,011.50
|
| Rate for Payer: Aetna Medicare |
$309.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$371.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$371.88
|
| Rate for Payer: BCBS Complete |
$220.27
|
| Rate for Payer: BCBS MAPPO |
$297.50
|
| Rate for Payer: BCBS Trust/PPO |
$978.30
|
| Rate for Payer: BCN Commercial |
$978.30
|
| Rate for Payer: BCN Medicare Advantage |
$297.50
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$1,023.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$952.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.50
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$892.50
|
| Rate for Payer: Mclaren Medicaid |
$209.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.38
|
| Rate for Payer: Meridian Medicaid |
$220.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$327.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.50
|
| Rate for Payer: Nomi Health Commercial |
$975.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE Senior Care Partners |
$282.62
|
| Rate for Payer: PACE SWMI |
$297.50
|
| Rate for Payer: PHP Commercial |
$1,011.50
|
| Rate for Payer: PHP Medicare Advantage |
$297.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,035.30
|
| Rate for Payer: Priority Health Medicare |
$300.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$828.24
|
| Rate for Payer: Railroad Medicare Medicare |
$297.50
|
| Rate for Payer: UHC Core |
$993.65
|
| Rate for Payer: UHC Exchange |
$297.50
|
| Rate for Payer: UHC Medicaid |
$209.80
|
| Rate for Payer: UHC Medicare Advantage |
$297.50
|
| Rate for Payer: UHCCP Medicaid |
$209.80
|
| Rate for Payer: VA VA |
$297.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$892.50
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
24076
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$894.31 |
| Rate for Payer: Aetna Commercial |
$725.09
|
| Rate for Payer: Aetna Medicare |
$595.00
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Mclaren Medicaid |
$332.28
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$894.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$894.31
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$1,190.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$828.24 |
| Max. Negotiated Rate |
$1,071.00 |
| Rate for Payer: Aetna Commercial |
$1,011.50
|
| Rate for Payer: BCBS Trust/PPO |
$982.82
|
| Rate for Payer: BCN Commercial |
$982.82
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$1,023.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$952.00
|
| Rate for Payer: Healthscope Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$892.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.50
|
| Rate for Payer: Nomi Health Commercial |
$975.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PHP Commercial |
$1,011.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,035.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$828.24
|
| Rate for Payer: UHC Core |
$993.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$892.50
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$894.31 |
| Rate for Payer: Aetna Commercial |
$725.09
|
| Rate for Payer: Aetna Medicare |
$595.00
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Mclaren Medicaid |
$332.28
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$894.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$894.31
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$438.57
|
| Rate for Payer: Aetna Medicare |
$561.00
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCN Commercial |
$514.42
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$549.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.90
|
| Rate for Payer: UHC Medicaid |
$204.91
|
| Rate for Payer: UHCCP Medicaid |
$204.91
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$780.91 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: BCBS Trust/PPO |
$926.66
|
| Rate for Payer: BCN Commercial |
$926.66
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$976.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.91
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$197.81 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$291.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.62
|
| Rate for Payer: BCBS Complete |
$207.68
|
| Rate for Payer: BCBS MAPPO |
$280.50
|
| Rate for Payer: BCBS Trust/PPO |
$922.40
|
| Rate for Payer: BCN Commercial |
$922.40
|
| Rate for Payer: BCN Medicare Advantage |
$280.50
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.50
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Mclaren Medicaid |
$197.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.52
|
| Rate for Payer: Meridian Medicaid |
$207.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE Senior Care Partners |
$266.48
|
| Rate for Payer: PACE SWMI |
$280.50
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$280.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$976.14
|
| Rate for Payer: Priority Health Medicare |
$283.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$780.91
|
| Rate for Payer: Railroad Medicare Medicare |
$280.50
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: UHC Exchange |
$280.50
|
| Rate for Payer: UHC Medicaid |
$197.81
|
| Rate for Payer: UHC Medicare Advantage |
$280.50
|
| Rate for Payer: UHCCP Medicaid |
$197.81
|
| Rate for Payer: VA VA |
$280.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$438.57
|
| Rate for Payer: Aetna Medicare |
$561.00
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCN Commercial |
$514.42
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Mclaren Medicaid |
$204.91
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$549.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.90
|
| Rate for Payer: UHC Medicaid |
$204.91
|
| Rate for Payer: UHCCP Medicaid |
$204.91
|
|
