|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$2,226.78 |
| Rate for Payer: Aetna Commercial |
$145.34
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: BCBS Complete |
$76.93
|
| Rate for Payer: BCBS MAPPO |
$108.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.78
|
| Rate for Payer: BCN Commercial |
$314.22
|
| Rate for Payer: BCN Medicare Advantage |
$108.46
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$145.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.46
|
| Rate for Payer: Mclaren Medicaid |
$73.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.88
|
| Rate for Payer: Meridian Medicaid |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$130.15
|
| Rate for Payer: PACE SWMI |
$108.46
|
| Rate for Payer: PHP Medicare Advantage |
$108.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health HMO/PPO |
$204.64
|
| Rate for Payer: Priority Health Medicare |
$109.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.46
|
| Rate for Payer: UHC Exchange |
$108.46
|
| Rate for Payer: UHC Medicare Advantage |
$108.46
|
| Rate for Payer: UHCCP Medicaid |
$73.27
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$812.52
|
| Rate for Payer: Aetna Medicare |
$630.61
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$606.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$933.86
|
| Rate for Payer: BCN Medicare Advantage |
$606.36
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$873.16
|
| Rate for Payer: Cofinity Commercial |
$812.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.36
|
| Rate for Payer: Mclaren Medicaid |
$412.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.68
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Nomi Health Commercial |
$727.63
|
| Rate for Payer: PACE SWMI |
$606.36
|
| Rate for Payer: PHP Medicare Advantage |
$606.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health HMO/PPO |
$867.36
|
| Rate for Payer: Priority Health Medicare |
$612.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$867.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.36
|
| Rate for Payer: UHC Exchange |
$606.36
|
| Rate for Payer: UHC Medicare Advantage |
$606.36
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$1,702.06 |
| Rate for Payer: Aetna Commercial |
$1,494.66
|
| Rate for Payer: Aetna Medicare |
$1,160.04
|
| Rate for Payer: BCBS Complete |
$788.14
|
| Rate for Payer: BCBS MAPPO |
$1,115.42
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$1,702.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,115.42
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,606.20
|
| Rate for Payer: Cofinity Commercial |
$1,494.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,115.42
|
| Rate for Payer: Mclaren Medicaid |
$750.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,171.19
|
| Rate for Payer: Meridian Medicaid |
$788.14
|
| Rate for Payer: Nomi Health Commercial |
$1,338.50
|
| Rate for Payer: PACE SWMI |
$1,115.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,115.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$750.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,611.01
|
| Rate for Payer: Priority Health Medicare |
$1,126.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,611.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,115.42
|
| Rate for Payer: UHC Exchange |
$1,115.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,115.42
|
| Rate for Payer: UHCCP Medicaid |
$750.61
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$529.15 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna Medicare |
$579.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.25
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$557.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.64
|
| Rate for Payer: BCN Commercial |
$1,732.27
|
| Rate for Payer: BCN Medicare Advantage |
$557.00
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.00
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.85
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: Nomi Health Commercial |
$1,826.96
|
| Rate for Payer: PACE Senior Care Partners |
$529.15
|
| Rate for Payer: PACE SWMI |
$557.00
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: PHP Medicare Advantage |
$557.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,938.36
|
| Rate for Payer: Priority Health Medicare |
$562.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,492.76
|
| Rate for Payer: Railroad Medicare Medicare |
$557.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,960.64
|
| Rate for Payer: UHC Core |
$1,860.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.00
|
| Rate for Payer: UHC Exchange |
$557.00
|
| Rate for Payer: UHC Medicare Advantage |
$557.00
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$557.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$1,448.20 |
| Max. Negotiated Rate |
$2,005.20 |
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,818.72
|
| Rate for Payer: BCN Commercial |
$1,721.80
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: Nomi Health Commercial |
$1,826.96
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,938.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,492.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,960.64
|
| Rate for Payer: UHC Core |
$1,860.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO |
$830.96
|
| Rate for Payer: Priority Health Medicare |
$524.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Exchange |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: BCBS Complete |
$369.24
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Mclaren Medicaid |
$351.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Meridian Medicaid |
$369.24
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health HMO/PPO |
$830.96
|
| Rate for Payer: Priority Health Medicare |
$524.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Exchange |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UHCCP Medicaid |
$351.66
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$292.84 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna Medicare |
$320.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.31
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$308.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.65
|
| Rate for Payer: BCN Commercial |
$958.66
|
| Rate for Payer: BCN Medicare Advantage |
$308.25
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.25
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.66
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$1,011.06
|
| Rate for Payer: PACE Senior Care Partners |
$292.84
|
| Rate for Payer: PACE SWMI |
$308.25
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: PHP Medicare Advantage |
$308.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.71
|
| Rate for Payer: Priority Health Medicare |
$311.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.11
|
| Rate for Payer: Railroad Medicare Medicare |
$308.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.04
|
| Rate for Payer: UHC Core |
$1,029.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.25
|
| Rate for Payer: UHC Exchange |
$308.25
|
| Rate for Payer: UHC Medicare Advantage |
$308.25
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$308.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: BCBS Complete |
$305.51
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Mclaren Medicaid |
$290.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Meridian Medicaid |
$305.51
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO |
$690.02
|
| Rate for Payer: Priority Health Medicare |
$438.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Exchange |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP Medicaid |
$290.96
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$801.45 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.50
|
| Rate for Payer: BCN Commercial |
$952.86
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$1,011.06
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,085.04
|
| Rate for Payer: UHC Core |
$1,029.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: BCBS Complete |
$305.51
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Mclaren Medicaid |
$290.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Meridian Medicaid |
$305.51
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO |
$690.02
|
| Rate for Payer: Priority Health Medicare |
$438.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Exchange |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP Medicaid |
$290.96
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$770.25 |
| Max. Negotiated Rate |
$1,066.50 |
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: BCBS Trust/PPO |
$967.32
|
| Rate for Payer: BCN Commercial |
$915.77
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,030.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$793.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,042.80
|
| Rate for Payer: UHC Core |
$989.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,134.25 |
| Rate for Payer: Aetna Commercial |
$958.44
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.44
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Mclaren Medicaid |
$477.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$722.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,134.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Exchange |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,134.25 |
| Rate for Payer: Aetna Commercial |
$958.44
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.44
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Mclaren Medicaid |
$477.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Meridian Medicaid |
$501.87
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$722.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,134.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Exchange |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$281.44 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna Medicare |
$308.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.31
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$296.25
|
| Rate for Payer: BCBS Trust/PPO |
$974.19
|
| Rate for Payer: BCN Commercial |
$921.34
|
| Rate for Payer: BCN Medicare Advantage |
$296.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.75
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.06
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| Rate for Payer: PACE Senior Care Partners |
$281.44
|
| Rate for Payer: PACE SWMI |
$296.25
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: PHP Medicare Advantage |
$296.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,030.95
|
| Rate for Payer: Priority Health Medicare |
$299.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$793.95
|
| Rate for Payer: Railroad Medicare Medicare |
$296.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,042.80
|
| Rate for Payer: UHC Core |
$989.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.25
|
| Rate for Payer: UHC Exchange |
$296.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.25
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$296.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Mclaren Medicaid |
$431.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,019.75
|
| Rate for Payer: Priority Health Medicare |
$651.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$644.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Exchange |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$478.56 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna Medicare |
$523.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$629.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$629.69
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$503.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,656.53
|
| Rate for Payer: BCN Commercial |
$1,566.66
|
| Rate for Payer: BCN Medicare Advantage |
$503.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.75
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$528.94
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$579.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: PACE Senior Care Partners |
$478.56
|
| Rate for Payer: PACE SWMI |
$503.75
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: PHP Medicare Advantage |
$503.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,753.05
|
| Rate for Payer: Priority Health Medicare |
$508.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,350.05
|
| Rate for Payer: Railroad Medicare Medicare |
$503.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,773.20
|
| Rate for Payer: UHC Core |
$1,682.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.75
|
| Rate for Payer: UHC Exchange |
$503.75
|
| Rate for Payer: UHC Medicare Advantage |
$503.75
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$503.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,309.75 |
| Max. Negotiated Rate |
$1,813.50 |
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.84
|
| Rate for Payer: BCN Commercial |
$1,557.19
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,753.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,350.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,773.20
|
| Rate for Payer: UHC Core |
$1,682.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Mclaren Medicaid |
$431.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,019.75
|
| Rate for Payer: Priority Health Medicare |
$651.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$644.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Exchange |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$573.95 |
| Max. Negotiated Rate |
$794.70 |
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: BCBS Trust/PPO |
$720.79
|
| Rate for Payer: BCN Commercial |
$682.38
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$759.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Healthscope Commercial |
$794.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$662.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: Nomi Health Commercial |
$724.06
|
| Rate for Payer: PHP Commercial |
$750.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO |
$768.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.04
|
| Rate for Payer: UHC Core |
$737.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$662.25
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Mclaren Medicaid |
$338.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Meridian Medicaid |
$355.38
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO |
$802.99
|
| Rate for Payer: Priority Health Medicare |
$505.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Exchange |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Mclaren Medicaid |
$338.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Meridian Medicaid |
$355.38
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO |
$802.99
|
| Rate for Payer: Priority Health Medicare |
$505.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Exchange |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$209.71 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: Aetna Medicare |
$229.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$275.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$275.94
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$220.75
|
| Rate for Payer: BCBS Trust/PPO |
$725.91
|
| Rate for Payer: BCN Commercial |
$686.53
|
| Rate for Payer: BCN Medicare Advantage |
$220.75
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$759.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.75
|
| Rate for Payer: Healthscope Commercial |
$794.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$662.25
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.79
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$253.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: Nomi Health Commercial |
$724.06
|
| Rate for Payer: PACE Senior Care Partners |
$209.71
|
| Rate for Payer: PACE SWMI |
$220.75
|
| Rate for Payer: PHP Commercial |
$750.55
|
| Rate for Payer: PHP Medicare Advantage |
$220.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO |
$768.21
|
| Rate for Payer: Priority Health Medicare |
$222.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.61
|
| Rate for Payer: Railroad Medicare Medicare |
$220.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.04
|
| Rate for Payer: UHC Core |
$737.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$220.75
|
| Rate for Payer: UHC Exchange |
$220.75
|
| Rate for Payer: UHC Medicare Advantage |
$220.75
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$220.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$662.25
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$260.50 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$514.61
|
| Rate for Payer: Aetna Medicare |
$399.40
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS MAPPO |
$384.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$789.70
|
| Rate for Payer: BCN Medicare Advantage |
$384.04
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$553.02
|
| Rate for Payer: Cofinity Commercial |
$514.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.04
|
| Rate for Payer: Mclaren Medicaid |
$260.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.24
|
| Rate for Payer: Meridian Medicaid |
$273.52
|
| Rate for Payer: Nomi Health Commercial |
$460.85
|
| Rate for Payer: PACE SWMI |
$384.04
|
| Rate for Payer: PHP Medicare Advantage |
$384.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO |
$619.29
|
| Rate for Payer: Priority Health Medicare |
$387.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.04
|
| Rate for Payer: UHC Exchange |
$384.04
|
| Rate for Payer: UHC Medicare Advantage |
$384.04
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$171.70 |
| Max. Negotiated Rate |
$1,047.15 |
| Rate for Payer: Aetna Commercial |
$551.34
|
| Rate for Payer: Aetna Medicare |
$427.91
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$411.45
|
| Rate for Payer: BCBS Trust/PPO |
$171.70
|
| Rate for Payer: BCN Commercial |
$624.04
|
| Rate for Payer: BCN Medicare Advantage |
$411.45
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cofinity Commercial |
$592.49
|
| Rate for Payer: Cofinity Commercial |
$551.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.45
|
| Rate for Payer: Mclaren Medicaid |
$277.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.02
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Nomi Health Commercial |
$493.74
|
| Rate for Payer: PACE SWMI |
$411.45
|
| Rate for Payer: PHP Medicare Advantage |
$411.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health HMO/PPO |
$656.94
|
| Rate for Payer: Priority Health Medicare |
$415.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$411.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.45
|
| Rate for Payer: UHC Exchange |
$411.45
|
| Rate for Payer: UHC Medicare Advantage |
$411.45
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
