|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$235.09 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$672.95
|
| Rate for Payer: Aetna Medicare |
$522.29
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$502.20
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$767.22
|
| Rate for Payer: BCN Medicare Advantage |
$502.20
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$723.17
|
| Rate for Payer: Cofinity Commercial |
$672.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.20
|
| Rate for Payer: Mclaren Medicaid |
$341.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.31
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PACE SWMI |
$502.20
|
| Rate for Payer: PHP Medicare Advantage |
$502.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO |
$806.03
|
| Rate for Payer: Priority Health Medicare |
$507.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.20
|
| Rate for Payer: UHC Exchange |
$502.20
|
| Rate for Payer: UHC Medicare Advantage |
$502.20
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,127.10 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,415.46
|
| Rate for Payer: BCN Commercial |
$1,340.04
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,300.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: Nomi Health Commercial |
$1,421.88
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,508.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,525.92
|
| Rate for Payer: UHC Core |
$1,447.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Mclaren Medicaid |
$343.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO |
$816.21
|
| Rate for Payer: Priority Health Medicare |
$514.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$816.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Exchange |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$411.82 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna Medicare |
$450.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$541.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$541.88
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$433.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,425.52
|
| Rate for Payer: BCN Commercial |
$1,348.18
|
| Rate for Payer: BCN Medicare Advantage |
$433.50
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.50
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,300.50
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.18
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$498.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: Nomi Health Commercial |
$1,421.88
|
| Rate for Payer: PACE Senior Care Partners |
$411.82
|
| Rate for Payer: PACE SWMI |
$433.50
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: PHP Medicare Advantage |
$433.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,508.58
|
| Rate for Payer: Priority Health Medicare |
$437.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,161.78
|
| Rate for Payer: Railroad Medicare Medicare |
$433.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,525.92
|
| Rate for Payer: UHC Core |
$1,447.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.50
|
| Rate for Payer: UHC Exchange |
$433.50
|
| Rate for Payer: UHC Medicare Advantage |
$433.50
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$433.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Mclaren Medicaid |
$343.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO |
$816.21
|
| Rate for Payer: Priority Health Medicare |
$514.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$816.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Exchange |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$840.13 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Mclaren Medicaid |
$356.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO |
$840.13
|
| Rate for Payer: Priority Health Medicare |
$532.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$840.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Exchange |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$840.13 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Mclaren Medicaid |
$356.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO |
$840.13
|
| Rate for Payer: Priority Health Medicare |
$532.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$840.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Exchange |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$242.72 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna Medicare |
$265.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$319.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$319.38
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$255.50
|
| Rate for Payer: BCBS Trust/PPO |
$840.19
|
| Rate for Payer: BCN Commercial |
$794.60
|
| Rate for Payer: BCN Medicare Advantage |
$255.50
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.50
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$766.50
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.28
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: PACE Senior Care Partners |
$242.72
|
| Rate for Payer: PACE SWMI |
$255.50
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: PHP Medicare Advantage |
$255.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO |
$889.14
|
| Rate for Payer: Priority Health Medicare |
$258.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.74
|
| Rate for Payer: Railroad Medicare Medicare |
$255.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$899.36
|
| Rate for Payer: UHC Core |
$853.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.50
|
| Rate for Payer: UHC Exchange |
$255.50
|
| Rate for Payer: UHC Medicare Advantage |
$255.50
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$255.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$766.50
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$664.30 |
| Max. Negotiated Rate |
$919.80 |
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: BCBS Trust/PPO |
$834.26
|
| Rate for Payer: BCN Commercial |
$789.80
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$766.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO |
$889.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$899.36
|
| Rate for Payer: UHC Core |
$853.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$766.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$872.70 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Mclaren Medicaid |
$368.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$555.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Exchange |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$872.70 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Mclaren Medicaid |
$368.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$555.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Exchange |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$754.65 |
| Max. Negotiated Rate |
$1,044.90 |
| Rate for Payer: Aetna Commercial |
$986.85
|
| Rate for Payer: BCBS Trust/PPO |
$947.72
|
| Rate for Payer: BCN Commercial |
$897.22
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$998.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Healthscope Commercial |
$1,044.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.85
|
| Rate for Payer: Nomi Health Commercial |
$952.02
|
| Rate for Payer: PHP Commercial |
$986.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,010.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.68
|
| Rate for Payer: UHC Core |
$969.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.75
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$275.74 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$986.85
|
| Rate for Payer: Aetna Medicare |
$301.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.81
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$290.25
|
| Rate for Payer: BCBS Trust/PPO |
$954.46
|
| Rate for Payer: BCN Commercial |
$902.68
|
| Rate for Payer: BCN Medicare Advantage |
$290.25
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$998.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.25
|
| Rate for Payer: Healthscope Commercial |
$1,044.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.75
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.76
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.85
|
| Rate for Payer: Nomi Health Commercial |
$952.02
|
| Rate for Payer: PACE Senior Care Partners |
$275.74
|
| Rate for Payer: PACE SWMI |
$290.25
|
| Rate for Payer: PHP Commercial |
$986.85
|
| Rate for Payer: PHP Medicare Advantage |
$290.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,010.07
|
| Rate for Payer: Priority Health Medicare |
$293.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.87
|
| Rate for Payer: Railroad Medicare Medicare |
$290.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.68
|
| Rate for Payer: UHC Core |
$969.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.25
|
| Rate for Payer: UHC Exchange |
$290.25
|
| Rate for Payer: UHC Medicare Advantage |
$290.25
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$290.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.75
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,203.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$132.44 |
| Max. Negotiated Rate |
$1,025.35 |
| Rate for Payer: Aetna Commercial |
$868.23
|
| Rate for Payer: Aetna Medicare |
$673.85
|
| Rate for Payer: BCBS Complete |
$454.23
|
| Rate for Payer: BCBS MAPPO |
$647.93
|
| Rate for Payer: BCBS Trust/PPO |
$132.44
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$647.93
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cofinity Commercial |
$933.02
|
| Rate for Payer: Cofinity Commercial |
$868.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.93
|
| Rate for Payer: Mclaren Medicaid |
$432.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.33
|
| Rate for Payer: Meridian Medicaid |
$454.23
|
| Rate for Payer: Nomi Health Commercial |
$777.52
|
| Rate for Payer: PACE SWMI |
$647.93
|
| Rate for Payer: PHP Medicare Advantage |
$647.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,025.35
|
| Rate for Payer: Priority Health Medicare |
$654.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.93
|
| Rate for Payer: UHC Exchange |
$647.93
|
| Rate for Payer: UHC Medicare Advantage |
$647.93
|
| Rate for Payer: UHCCP Medicaid |
$432.60
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: BCBS Trust/PPO |
$582.84
|
| Rate for Payer: BCN Commercial |
$551.78
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$621.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$679.33 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$445.30
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS MAPPO |
$428.17
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: BCN Medicare Advantage |
$428.17
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$616.56
|
| Rate for Payer: Cofinity Commercial |
$573.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.17
|
| Rate for Payer: Mclaren Medicaid |
$286.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.58
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Nomi Health Commercial |
$513.80
|
| Rate for Payer: PACE SWMI |
$428.17
|
| Rate for Payer: PHP Medicare Advantage |
$428.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$679.33
|
| Rate for Payer: Priority Health Medicare |
$432.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$679.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.17
|
| Rate for Payer: UHC Exchange |
$428.17
|
| Rate for Payer: UHC Medicare Advantage |
$428.17
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$679.33 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$445.30
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS MAPPO |
$428.17
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: BCN Medicare Advantage |
$428.17
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$616.56
|
| Rate for Payer: Cofinity Commercial |
$573.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.17
|
| Rate for Payer: Mclaren Medicaid |
$286.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.58
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Nomi Health Commercial |
$513.80
|
| Rate for Payer: PACE SWMI |
$428.17
|
| Rate for Payer: PHP Medicare Advantage |
$428.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$679.33
|
| Rate for Payer: Priority Health Medicare |
$432.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$679.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.17
|
| Rate for Payer: UHC Exchange |
$428.17
|
| Rate for Payer: UHC Medicare Advantage |
$428.17
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$169.58 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$185.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.12
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$178.50
|
| Rate for Payer: BCBS Trust/PPO |
$586.98
|
| Rate for Payer: BCN Commercial |
$555.14
|
| Rate for Payer: BCN Medicare Advantage |
$178.50
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.50
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.42
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PACE Senior Care Partners |
$169.58
|
| Rate for Payer: PACE SWMI |
$178.50
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$178.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$621.18
|
| Rate for Payer: Priority Health Medicare |
$180.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.38
|
| Rate for Payer: Railroad Medicare Medicare |
$178.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.50
|
| Rate for Payer: UHC Exchange |
$178.50
|
| Rate for Payer: UHC Medicare Advantage |
$178.50
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$178.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$216.50 |
| Max. Negotiated Rate |
$694.90 |
| Rate for Payer: Aetna Commercial |
$433.09
|
| Rate for Payer: Aetna Medicare |
$336.13
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$323.20
|
| Rate for Payer: BCBS Trust/PPO |
$216.50
|
| Rate for Payer: BCN Commercial |
$694.90
|
| Rate for Payer: BCN Medicare Advantage |
$323.20
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$465.41
|
| Rate for Payer: Cofinity Commercial |
$433.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.20
|
| Rate for Payer: Mclaren Medicaid |
$218.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.36
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Nomi Health Commercial |
$387.84
|
| Rate for Payer: PACE SWMI |
$323.20
|
| Rate for Payer: PHP Medicare Advantage |
$323.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.15
|
| Rate for Payer: Priority Health HMO/PPO |
$517.00
|
| Rate for Payer: Priority Health Medicare |
$326.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.20
|
| Rate for Payer: UHC Exchange |
$323.20
|
| Rate for Payer: UHC Medicare Advantage |
$323.20
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$577.78
|
| Rate for Payer: Aetna Medicare |
$448.43
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$431.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$431.18
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$620.90
|
| Rate for Payer: Cofinity Commercial |
$577.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.18
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.74
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Nomi Health Commercial |
$517.42
|
| Rate for Payer: PACE SWMI |
$431.18
|
| Rate for Payer: PHP Medicare Advantage |
$431.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO |
$693.58
|
| Rate for Payer: Priority Health Medicare |
$435.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$693.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.18
|
| Rate for Payer: UHC Exchange |
$431.18
|
| Rate for Payer: UHC Medicare Advantage |
$431.18
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
IP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$783.90 |
| Max. Negotiated Rate |
$1,085.40 |
| Rate for Payer: Aetna Commercial |
$1,025.10
|
| Rate for Payer: BCBS Trust/PPO |
$984.46
|
| Rate for Payer: BCN Commercial |
$932.00
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$1,037.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Healthscope Commercial |
$1,085.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$904.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,025.10
|
| Rate for Payer: Nomi Health Commercial |
$988.92
|
| Rate for Payer: PHP Commercial |
$1,025.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,049.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$808.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,061.28
|
| Rate for Payer: UHC Core |
$1,007.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$904.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$577.78
|
| Rate for Payer: Aetna Medicare |
$448.43
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS MAPPO |
$431.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$431.18
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$620.90
|
| Rate for Payer: Cofinity Commercial |
$577.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.18
|
| Rate for Payer: Mclaren Medicaid |
$291.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.74
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Nomi Health Commercial |
$517.42
|
| Rate for Payer: PACE SWMI |
$431.18
|
| Rate for Payer: PHP Medicare Advantage |
$431.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO |
$693.58
|
| Rate for Payer: Priority Health Medicare |
$435.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$693.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.18
|
| Rate for Payer: UHC Exchange |
$431.18
|
| Rate for Payer: UHC Medicare Advantage |
$431.18
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
OP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$286.42 |
| Max. Negotiated Rate |
$2,128.93 |
| Rate for Payer: Aetna Commercial |
$1,025.10
|
| Rate for Payer: Aetna Medicare |
$313.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.88
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$301.50
|
| Rate for Payer: BCBS Trust/PPO |
$991.45
|
| Rate for Payer: BCN Commercial |
$937.66
|
| Rate for Payer: BCN Medicare Advantage |
$301.50
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$1,037.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.50
|
| Rate for Payer: Healthscope Commercial |
$1,085.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$904.50
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.58
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,025.10
|
| Rate for Payer: Nomi Health Commercial |
$988.92
|
| Rate for Payer: PACE Senior Care Partners |
$286.42
|
| Rate for Payer: PACE SWMI |
$301.50
|
| Rate for Payer: PHP Commercial |
$1,025.10
|
| Rate for Payer: PHP Medicare Advantage |
$301.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,049.22
|
| Rate for Payer: Priority Health Medicare |
$304.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$808.02
|
| Rate for Payer: Railroad Medicare Medicare |
$301.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,061.28
|
| Rate for Payer: UHC Core |
$1,007.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.50
|
| Rate for Payer: UHC Exchange |
$301.50
|
| Rate for Payer: UHC Medicare Advantage |
$301.50
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$301.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$904.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$700.27 |
| Rate for Payer: Aetna Commercial |
$447.57
|
| Rate for Payer: Aetna Medicare |
$347.37
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCBS MAPPO |
$334.01
|
| Rate for Payer: BCBS Trust/PPO |
$699.47
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$334.01
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cofinity Commercial |
$480.97
|
| Rate for Payer: Cofinity Commercial |
$447.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.01
|
| Rate for Payer: Mclaren Medicaid |
$226.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.71
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Nomi Health Commercial |
$400.81
|
| Rate for Payer: PACE SWMI |
$334.01
|
| Rate for Payer: PHP Medicare Advantage |
$334.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.65
|
| Rate for Payer: Priority Health HMO/PPO |
$534.31
|
| Rate for Payer: Priority Health Medicare |
$337.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$534.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$334.01
|
| Rate for Payer: UHC Exchange |
$334.01
|
| Rate for Payer: UHC Medicare Advantage |
$334.01
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$279.06 |
| Max. Negotiated Rate |
$1,205.21 |
| Rate for Payer: Aetna Commercial |
$998.75
|
| Rate for Payer: Aetna Medicare |
$305.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.19
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$293.75
|
| Rate for Payer: BCBS Trust/PPO |
$965.97
|
| Rate for Payer: BCN Commercial |
$913.56
|
| Rate for Payer: BCN Medicare Advantage |
$293.75
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,010.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.75
|
| Rate for Payer: Healthscope Commercial |
$1,057.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$881.25
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.44
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$337.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: PACE Senior Care Partners |
$279.06
|
| Rate for Payer: PACE SWMI |
$293.75
|
| Rate for Payer: PHP Commercial |
$998.75
|
| Rate for Payer: PHP Medicare Advantage |
$293.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,022.25
|
| Rate for Payer: Priority Health Medicare |
$296.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.25
|
| Rate for Payer: Railroad Medicare Medicare |
$293.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.00
|
| Rate for Payer: UHC Core |
$981.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.75
|
| Rate for Payer: UHC Exchange |
$293.75
|
| Rate for Payer: UHC Medicare Advantage |
$293.75
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$293.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$881.25
|
|
