|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$523.90 |
| Rate for Payer: Aetna Commercial |
$396.44
|
| Rate for Payer: Aetna Medicare |
$307.68
|
| Rate for Payer: BCBS Complete |
$322.40
|
| Rate for Payer: BCBS MAPPO |
$295.85
|
| Rate for Payer: BCN Medicare Advantage |
$295.85
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$426.02
|
| Rate for Payer: Cofinity Commercial |
$396.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.64
|
| Rate for Payer: Nomi Health Commercial |
$355.02
|
| Rate for Payer: PACE SWMI |
$295.85
|
| Rate for Payer: PHP Medicare Advantage |
$295.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health Medicare |
$298.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.85
|
| Rate for Payer: UHC Exchange |
$295.85
|
| Rate for Payer: UHC Medicare Advantage |
$295.85
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$523.90 |
| Rate for Payer: Aetna Commercial |
$396.44
|
| Rate for Payer: Aetna Medicare |
$307.68
|
| Rate for Payer: BCBS Complete |
$322.40
|
| Rate for Payer: BCBS MAPPO |
$295.85
|
| Rate for Payer: BCN Medicare Advantage |
$295.85
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$426.02
|
| Rate for Payer: Cofinity Commercial |
$396.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.64
|
| Rate for Payer: Nomi Health Commercial |
$355.02
|
| Rate for Payer: PACE SWMI |
$295.85
|
| Rate for Payer: PHP Medicare Advantage |
$295.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health Medicare |
$298.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.85
|
| Rate for Payer: UHC Exchange |
$295.85
|
| Rate for Payer: UHC Medicare Advantage |
$295.85
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$806.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$191.43 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$685.10
|
| Rate for Payer: Aetna Medicare |
$209.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.88
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$201.50
|
| Rate for Payer: BCBS Trust/PPO |
$662.61
|
| Rate for Payer: BCN Commercial |
$626.66
|
| Rate for Payer: BCN Medicare Advantage |
$201.50
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$693.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.50
|
| Rate for Payer: Healthscope Commercial |
$725.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$604.50
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.57
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: Nomi Health Commercial |
$660.92
|
| Rate for Payer: PACE Senior Care Partners |
$191.43
|
| Rate for Payer: PACE SWMI |
$201.50
|
| Rate for Payer: PHP Commercial |
$685.10
|
| Rate for Payer: PHP Medicare Advantage |
$201.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO |
$701.22
|
| Rate for Payer: Priority Health Medicare |
$203.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.02
|
| Rate for Payer: Railroad Medicare Medicare |
$201.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.28
|
| Rate for Payer: UHC Core |
$673.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.50
|
| Rate for Payer: UHC Exchange |
$201.50
|
| Rate for Payer: UHC Medicare Advantage |
$201.50
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$201.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$604.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$806.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$523.90 |
| Max. Negotiated Rate |
$725.40 |
| Rate for Payer: Aetna Commercial |
$685.10
|
| Rate for Payer: BCBS Trust/PPO |
$657.94
|
| Rate for Payer: BCN Commercial |
$622.88
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$693.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.80
|
| Rate for Payer: Healthscope Commercial |
$725.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$604.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: Nomi Health Commercial |
$660.92
|
| Rate for Payer: PHP Commercial |
$685.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO |
$701.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.28
|
| Rate for Payer: UHC Core |
$673.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$604.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
OP
|
$2,144.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$509.20 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$1,822.40
|
| Rate for Payer: Aetna Medicare |
$557.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.00
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$536.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,762.58
|
| Rate for Payer: BCN Commercial |
$1,666.96
|
| Rate for Payer: BCN Medicare Advantage |
$536.00
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$1,843.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,715.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.00
|
| Rate for Payer: Healthscope Commercial |
$1,929.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,608.00
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.80
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$616.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,822.40
|
| Rate for Payer: Nomi Health Commercial |
$1,758.08
|
| Rate for Payer: PACE Senior Care Partners |
$509.20
|
| Rate for Payer: PACE SWMI |
$536.00
|
| Rate for Payer: PHP Commercial |
$1,822.40
|
| Rate for Payer: PHP Medicare Advantage |
$536.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,865.28
|
| Rate for Payer: Priority Health Medicare |
$541.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.48
|
| Rate for Payer: Railroad Medicare Medicare |
$536.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,886.72
|
| Rate for Payer: UHC Core |
$1,790.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.00
|
| Rate for Payer: UHC Exchange |
$536.00
|
| Rate for Payer: UHC Medicare Advantage |
$536.00
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$536.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,608.00
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$707.57 |
| Max. Negotiated Rate |
$1,393.60 |
| Rate for Payer: Aetna Commercial |
$948.14
|
| Rate for Payer: Aetna Medicare |
$735.87
|
| Rate for Payer: BCBS Complete |
$857.60
|
| Rate for Payer: BCBS MAPPO |
$707.57
|
| Rate for Payer: BCN Medicare Advantage |
$707.57
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$948.14
|
| Rate for Payer: Cofinity Commercial |
$1,018.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.95
|
| Rate for Payer: Nomi Health Commercial |
$849.08
|
| Rate for Payer: PACE SWMI |
$707.57
|
| Rate for Payer: PHP Medicare Advantage |
$707.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health Medicare |
$714.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$707.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.57
|
| Rate for Payer: UHC Exchange |
$707.57
|
| Rate for Payer: UHC Medicare Advantage |
$707.57
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$707.57 |
| Max. Negotiated Rate |
$1,393.60 |
| Rate for Payer: Aetna Commercial |
$948.14
|
| Rate for Payer: Aetna Medicare |
$735.87
|
| Rate for Payer: BCBS Complete |
$857.60
|
| Rate for Payer: BCBS MAPPO |
$707.57
|
| Rate for Payer: BCN Medicare Advantage |
$707.57
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$948.14
|
| Rate for Payer: Cofinity Commercial |
$1,018.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.95
|
| Rate for Payer: Nomi Health Commercial |
$849.08
|
| Rate for Payer: PACE SWMI |
$707.57
|
| Rate for Payer: PHP Medicare Advantage |
$707.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health Medicare |
$714.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$707.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.57
|
| Rate for Payer: UHC Exchange |
$707.57
|
| Rate for Payer: UHC Medicare Advantage |
$707.57
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
IP
|
$2,144.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,393.60 |
| Max. Negotiated Rate |
$1,929.60 |
| Rate for Payer: Aetna Commercial |
$1,822.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.15
|
| Rate for Payer: BCN Commercial |
$1,656.88
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$1,843.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,715.20
|
| Rate for Payer: Healthscope Commercial |
$1,929.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,608.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,822.40
|
| Rate for Payer: Nomi Health Commercial |
$1,758.08
|
| Rate for Payer: PHP Commercial |
$1,822.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,865.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,886.72
|
| Rate for Payer: UHC Core |
$1,790.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,608.00
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$507.60 |
| Max. Negotiated Rate |
$856.96 |
| Rate for Payer: Aetna Commercial |
$797.45
|
| Rate for Payer: Aetna Medicare |
$618.91
|
| Rate for Payer: BCBS Complete |
$507.60
|
| Rate for Payer: BCBS MAPPO |
$595.11
|
| Rate for Payer: BCN Medicare Advantage |
$595.11
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$856.96
|
| Rate for Payer: Cofinity Commercial |
$797.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.87
|
| Rate for Payer: Nomi Health Commercial |
$714.13
|
| Rate for Payer: PACE SWMI |
$595.11
|
| Rate for Payer: PHP Medicare Advantage |
$595.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health Medicare |
$601.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.11
|
| Rate for Payer: UHC Exchange |
$595.11
|
| Rate for Payer: UHC Medicare Advantage |
$595.11
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
OP
|
$1,269.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$301.39 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$1,078.65
|
| Rate for Payer: Aetna Medicare |
$329.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.56
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$317.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.24
|
| Rate for Payer: BCN Commercial |
$986.65
|
| Rate for Payer: BCN Medicare Advantage |
$317.25
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$1,091.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.25
|
| Rate for Payer: Healthscope Commercial |
$1,142.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.75
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$333.11
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,078.65
|
| Rate for Payer: Nomi Health Commercial |
$1,040.58
|
| Rate for Payer: PACE Senior Care Partners |
$301.39
|
| Rate for Payer: PACE SWMI |
$317.25
|
| Rate for Payer: PHP Commercial |
$1,078.65
|
| Rate for Payer: PHP Medicare Advantage |
$317.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,104.03
|
| Rate for Payer: Priority Health Medicare |
$320.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.23
|
| Rate for Payer: Railroad Medicare Medicare |
$317.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,116.72
|
| Rate for Payer: UHC Core |
$1,059.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$317.25
|
| Rate for Payer: UHC Exchange |
$317.25
|
| Rate for Payer: UHC Medicare Advantage |
$317.25
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$317.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.75
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$507.60 |
| Max. Negotiated Rate |
$856.96 |
| Rate for Payer: Aetna Commercial |
$797.45
|
| Rate for Payer: Aetna Medicare |
$618.91
|
| Rate for Payer: BCBS Complete |
$507.60
|
| Rate for Payer: BCBS MAPPO |
$595.11
|
| Rate for Payer: BCN Medicare Advantage |
$595.11
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$856.96
|
| Rate for Payer: Cofinity Commercial |
$797.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.87
|
| Rate for Payer: Nomi Health Commercial |
$714.13
|
| Rate for Payer: PACE SWMI |
$595.11
|
| Rate for Payer: PHP Medicare Advantage |
$595.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health Medicare |
$601.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.11
|
| Rate for Payer: UHC Exchange |
$595.11
|
| Rate for Payer: UHC Medicare Advantage |
$595.11
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
IP
|
$1,269.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$824.85 |
| Max. Negotiated Rate |
$1,142.10 |
| Rate for Payer: Aetna Commercial |
$1,078.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,035.88
|
| Rate for Payer: BCN Commercial |
$980.68
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$1,091.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.20
|
| Rate for Payer: Healthscope Commercial |
$1,142.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$951.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,078.65
|
| Rate for Payer: Nomi Health Commercial |
$1,040.58
|
| Rate for Payer: PHP Commercial |
$1,078.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,104.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,116.72
|
| Rate for Payer: UHC Core |
$1,059.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$951.75
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$1,399.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$559.60 |
| Max. Negotiated Rate |
$1,023.57 |
| Rate for Payer: Aetna Commercial |
$952.49
|
| Rate for Payer: Aetna Medicare |
$739.24
|
| Rate for Payer: BCBS Complete |
$559.60
|
| Rate for Payer: BCBS MAPPO |
$710.81
|
| Rate for Payer: BCN Medicare Advantage |
$710.81
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cofinity Commercial |
$952.49
|
| Rate for Payer: Cofinity Commercial |
$1,023.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$746.35
|
| Rate for Payer: Nomi Health Commercial |
$852.97
|
| Rate for Payer: PACE SWMI |
$710.81
|
| Rate for Payer: PHP Medicare Advantage |
$710.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.35
|
| Rate for Payer: Priority Health Medicare |
$717.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$710.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$710.81
|
| Rate for Payer: UHC Exchange |
$710.81
|
| Rate for Payer: UHC Medicare Advantage |
$710.81
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$522.60 |
| Rate for Payer: Aetna Commercial |
$468.28
|
| Rate for Payer: Aetna Medicare |
$363.44
|
| Rate for Payer: BCBS Complete |
$321.60
|
| Rate for Payer: BCBS MAPPO |
$349.46
|
| Rate for Payer: BCN Medicare Advantage |
$349.46
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$503.22
|
| Rate for Payer: Cofinity Commercial |
$468.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.93
|
| Rate for Payer: Nomi Health Commercial |
$419.35
|
| Rate for Payer: PACE SWMI |
$349.46
|
| Rate for Payer: PHP Medicare Advantage |
$349.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health Medicare |
$352.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.46
|
| Rate for Payer: UHC Exchange |
$349.46
|
| Rate for Payer: UHC Medicare Advantage |
$349.46
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$634.80 |
| Max. Negotiated Rate |
$1,031.55 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$701.92
|
| Rate for Payer: BCBS Complete |
$634.80
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health Medicare |
$681.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.92
|
| Rate for Payer: UHC Exchange |
$674.92
|
| Rate for Payer: UHC Medicare Advantage |
$674.92
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,587.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,031.55 |
| Max. Negotiated Rate |
$1,428.30 |
| Rate for Payer: Aetna Commercial |
$1,348.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,295.47
|
| Rate for Payer: BCN Commercial |
$1,226.43
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,364.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.60
|
| Rate for Payer: Healthscope Commercial |
$1,428.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,190.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.95
|
| Rate for Payer: Nomi Health Commercial |
$1,301.34
|
| Rate for Payer: PHP Commercial |
$1,348.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,380.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,396.56
|
| Rate for Payer: UHC Core |
$1,325.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,190.25
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,587.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$376.91 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$1,348.95
|
| Rate for Payer: Aetna Medicare |
$412.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$495.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$495.94
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$396.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,304.67
|
| Rate for Payer: BCN Commercial |
$1,233.89
|
| Rate for Payer: BCN Medicare Advantage |
$396.75
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,364.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.75
|
| Rate for Payer: Healthscope Commercial |
$1,428.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,190.25
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.59
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$456.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.95
|
| Rate for Payer: Nomi Health Commercial |
$1,301.34
|
| Rate for Payer: PACE Senior Care Partners |
$376.91
|
| Rate for Payer: PACE SWMI |
$396.75
|
| Rate for Payer: PHP Commercial |
$1,348.95
|
| Rate for Payer: PHP Medicare Advantage |
$396.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,380.69
|
| Rate for Payer: Priority Health Medicare |
$400.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.29
|
| Rate for Payer: Railroad Medicare Medicare |
$396.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,396.56
|
| Rate for Payer: UHC Core |
$1,325.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.75
|
| Rate for Payer: UHC Exchange |
$396.75
|
| Rate for Payer: UHC Medicare Advantage |
$396.75
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$396.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,190.25
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$634.80 |
| Max. Negotiated Rate |
$1,031.55 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$701.92
|
| Rate for Payer: BCBS Complete |
$634.80
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health Medicare |
$681.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.92
|
| Rate for Payer: UHC Exchange |
$674.92
|
| Rate for Payer: UHC Medicare Advantage |
$674.92
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$731.40 |
| Max. Negotiated Rate |
$2,129.40 |
| Rate for Payer: Aetna Commercial |
$980.08
|
| Rate for Payer: Aetna Medicare |
$760.66
|
| Rate for Payer: BCBS Complete |
$1,310.40
|
| Rate for Payer: BCBS MAPPO |
$731.40
|
| Rate for Payer: BCN Medicare Advantage |
$731.40
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$980.08
|
| Rate for Payer: Cofinity Commercial |
$1,053.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.97
|
| Rate for Payer: Nomi Health Commercial |
$877.68
|
| Rate for Payer: PACE SWMI |
$731.40
|
| Rate for Payer: PHP Medicare Advantage |
$731.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health Medicare |
$738.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.40
|
| Rate for Payer: UHC Exchange |
$731.40
|
| Rate for Payer: UHC Medicare Advantage |
$731.40
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,748.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$603.53 |
| Max. Negotiated Rate |
$1,136.20 |
| Rate for Payer: Aetna Commercial |
$808.73
|
| Rate for Payer: Aetna Medicare |
$627.67
|
| Rate for Payer: BCBS Complete |
$699.20
|
| Rate for Payer: BCBS MAPPO |
$603.53
|
| Rate for Payer: BCN Medicare Advantage |
$603.53
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cofinity Commercial |
$869.08
|
| Rate for Payer: Cofinity Commercial |
$808.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.71
|
| Rate for Payer: Nomi Health Commercial |
$724.24
|
| Rate for Payer: PACE SWMI |
$603.53
|
| Rate for Payer: PHP Medicare Advantage |
$603.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.20
|
| Rate for Payer: Priority Health Medicare |
$609.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$603.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.53
|
| Rate for Payer: UHC Exchange |
$603.53
|
| Rate for Payer: UHC Medicare Advantage |
$603.53
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$527.45
|
| Rate for Payer: Aetna Medicare |
$409.36
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$393.62
|
| Rate for Payer: BCN Medicare Advantage |
$393.62
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$566.81
|
| Rate for Payer: Cofinity Commercial |
$527.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.30
|
| Rate for Payer: Nomi Health Commercial |
$472.34
|
| Rate for Payer: PACE SWMI |
$393.62
|
| Rate for Payer: PHP Medicare Advantage |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$397.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.62
|
| Rate for Payer: UHC Exchange |
$393.62
|
| Rate for Payer: UHC Medicare Advantage |
$393.62
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,557.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,012.05 |
| Max. Negotiated Rate |
$1,401.30 |
| Rate for Payer: Aetna Commercial |
$1,323.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,270.98
|
| Rate for Payer: BCN Commercial |
$1,203.25
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,339.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Healthscope Commercial |
$1,401.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,323.45
|
| Rate for Payer: Nomi Health Commercial |
$1,276.74
|
| Rate for Payer: PHP Commercial |
$1,323.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,354.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,043.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,370.16
|
| Rate for Payer: UHC Core |
$1,300.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.75
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$527.45
|
| Rate for Payer: Aetna Medicare |
$409.36
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$393.62
|
| Rate for Payer: BCN Medicare Advantage |
$393.62
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$566.81
|
| Rate for Payer: Cofinity Commercial |
$527.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.30
|
| Rate for Payer: Nomi Health Commercial |
$472.34
|
| Rate for Payer: PACE SWMI |
$393.62
|
| Rate for Payer: PHP Medicare Advantage |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$397.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.62
|
| Rate for Payer: UHC Exchange |
$393.62
|
| Rate for Payer: UHC Medicare Advantage |
$393.62
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,557.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$369.79 |
| Max. Negotiated Rate |
$2,172.87 |
| Rate for Payer: Aetna Commercial |
$1,323.45
|
| Rate for Payer: Aetna Medicare |
$404.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.56
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$389.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.01
|
| Rate for Payer: BCN Commercial |
$1,210.57
|
| Rate for Payer: BCN Medicare Advantage |
$389.25
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,339.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.25
|
| Rate for Payer: Healthscope Commercial |
$1,401.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.75
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.71
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,323.45
|
| Rate for Payer: Nomi Health Commercial |
$1,276.74
|
| Rate for Payer: PACE Senior Care Partners |
$369.79
|
| Rate for Payer: PACE SWMI |
$389.25
|
| Rate for Payer: PHP Commercial |
$1,323.45
|
| Rate for Payer: PHP Medicare Advantage |
$389.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,354.59
|
| Rate for Payer: Priority Health Medicare |
$393.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,043.19
|
| Rate for Payer: Railroad Medicare Medicare |
$389.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,370.16
|
| Rate for Payer: UHC Core |
$1,300.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.25
|
| Rate for Payer: UHC Exchange |
$389.25
|
| Rate for Payer: UHC Medicare Advantage |
$389.25
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$389.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.75
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$843.05 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Aetna Commercial |
$1,102.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.74
|
| Rate for Payer: BCN Commercial |
$1,002.32
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Healthscope Commercial |
$1,167.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.45
|
| Rate for Payer: Nomi Health Commercial |
$1,063.54
|
| Rate for Payer: PHP Commercial |
$1,102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,128.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,141.36
|
| Rate for Payer: UHC Core |
$1,082.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.75
|
|
