|
PR RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,314.00
|
|
|
Service Code
|
HCPCS 24150
|
| Min. Negotiated Rate |
$925.60 |
| Max. Negotiated Rate |
$2,141.16 |
| Rate for Payer: Aetna Commercial |
$1,992.47
|
| Rate for Payer: Aetna Medicare |
$1,546.40
|
| Rate for Payer: BCBS Complete |
$925.60
|
| Rate for Payer: BCBS MAPPO |
$1,486.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,486.92
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cash Price |
$1,851.20
|
| Rate for Payer: Cofinity Commercial |
$2,141.16
|
| Rate for Payer: Cofinity Commercial |
$1,992.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,486.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,561.27
|
| Rate for Payer: Nomi Health Commercial |
$1,784.30
|
| Rate for Payer: PACE SWMI |
$1,486.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,486.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.10
|
| Rate for Payer: Priority Health Medicare |
$1,501.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,486.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,486.92
|
| Rate for Payer: UHC Exchange |
$1,486.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,486.92
|
|
|
PR RADICAL STYLOIDECTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,539.00
|
|
|
Service Code
|
HCPCS 25230
|
| Min. Negotiated Rate |
$421.03 |
| Max. Negotiated Rate |
$1,000.35 |
| Rate for Payer: Aetna Commercial |
$564.18
|
| Rate for Payer: Aetna Medicare |
$437.87
|
| Rate for Payer: BCBS Complete |
$615.60
|
| Rate for Payer: BCBS MAPPO |
$421.03
|
| Rate for Payer: BCN Medicare Advantage |
$421.03
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cofinity Commercial |
$606.28
|
| Rate for Payer: Cofinity Commercial |
$564.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.08
|
| Rate for Payer: Nomi Health Commercial |
$505.24
|
| Rate for Payer: PACE SWMI |
$421.03
|
| Rate for Payer: PHP Medicare Advantage |
$421.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,000.35
|
| Rate for Payer: Priority Health Medicare |
$425.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.03
|
| Rate for Payer: UHC Exchange |
$421.03
|
| Rate for Payer: UHC Medicare Advantage |
$421.03
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 64625
|
| Min. Negotiated Rate |
$186.42 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$249.80
|
| Rate for Payer: Aetna Medicare |
$193.88
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS MAPPO |
$186.42
|
| Rate for Payer: BCN Medicare Advantage |
$186.42
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$268.44
|
| Rate for Payer: Cofinity Commercial |
$249.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.74
|
| Rate for Payer: Nomi Health Commercial |
$223.70
|
| Rate for Payer: PACE SWMI |
$186.42
|
| Rate for Payer: PHP Medicare Advantage |
$186.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$188.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.42
|
| Rate for Payer: UHC Exchange |
$186.42
|
| Rate for Payer: UHC Medicare Advantage |
$186.42
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$186.42 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$249.80
|
| Rate for Payer: Aetna Medicare |
$193.88
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS MAPPO |
$186.42
|
| Rate for Payer: BCN Medicare Advantage |
$186.42
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$268.44
|
| Rate for Payer: Cofinity Commercial |
$249.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.74
|
| Rate for Payer: Nomi Health Commercial |
$223.70
|
| Rate for Payer: PACE SWMI |
$186.42
|
| Rate for Payer: PHP Medicare Advantage |
$186.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$188.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.42
|
| Rate for Payer: UHC Exchange |
$186.42
|
| Rate for Payer: UHC Medicare Advantage |
$186.42
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$221.82 |
| Max. Negotiated Rate |
$1,482.54 |
| Rate for Payer: Aetna Commercial |
$793.90
|
| Rate for Payer: Aetna Medicare |
$242.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$291.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$291.88
|
| Rate for Payer: BCBS Complete |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$233.50
|
| Rate for Payer: BCBS Trust/PPO |
$767.84
|
| Rate for Payer: BCN Commercial |
$726.18
|
| Rate for Payer: BCN Medicare Advantage |
$233.50
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$803.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.50
|
| Rate for Payer: Healthscope Commercial |
$840.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$700.50
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.18
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.90
|
| Rate for Payer: Nomi Health Commercial |
$765.88
|
| Rate for Payer: PACE Senior Care Partners |
$221.82
|
| Rate for Payer: PACE SWMI |
$233.50
|
| Rate for Payer: PHP Commercial |
$793.90
|
| Rate for Payer: PHP Medicare Advantage |
$233.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO |
$812.58
|
| Rate for Payer: Priority Health Medicare |
$235.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$625.78
|
| Rate for Payer: Railroad Medicare Medicare |
$233.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.92
|
| Rate for Payer: UHC Core |
$779.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.50
|
| Rate for Payer: UHC Exchange |
$233.50
|
| Rate for Payer: UHC Medicare Advantage |
$233.50
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$233.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$700.50
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
64625
|
| Min. Negotiated Rate |
$607.10 |
| Max. Negotiated Rate |
$840.60 |
| Rate for Payer: Aetna Commercial |
$793.90
|
| Rate for Payer: BCBS Trust/PPO |
$762.42
|
| Rate for Payer: BCN Commercial |
$721.80
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$803.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.20
|
| Rate for Payer: Healthscope Commercial |
$840.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$700.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.90
|
| Rate for Payer: Nomi Health Commercial |
$765.88
|
| Rate for Payer: PHP Commercial |
$793.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO |
$812.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$625.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.92
|
| Rate for Payer: UHC Core |
$779.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$700.50
|
|
|
PR RAD RESCJ CAPSL TISS&HTRTPC B1 ELBW CONTRCT RLS
|
Professional
|
Both
|
$2,668.00
|
|
|
Service Code
|
HCPCS 24149
|
| Min. Negotiated Rate |
$1,067.20 |
| Max. Negotiated Rate |
$1,734.20 |
| Rate for Payer: Aetna Commercial |
$1,522.51
|
| Rate for Payer: Aetna Medicare |
$1,181.65
|
| Rate for Payer: BCBS Complete |
$1,067.20
|
| Rate for Payer: BCBS MAPPO |
$1,136.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.20
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cash Price |
$2,134.40
|
| Rate for Payer: Cofinity Commercial |
$1,636.13
|
| Rate for Payer: Cofinity Commercial |
$1,522.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,193.01
|
| Rate for Payer: Nomi Health Commercial |
$1,363.44
|
| Rate for Payer: PACE SWMI |
$1,136.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,734.20
|
| Rate for Payer: Priority Health Medicare |
$1,147.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,136.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.20
|
| Rate for Payer: UHC Exchange |
$1,136.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.20
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW <5CM
|
Professional
|
Both
|
$1,847.00
|
|
|
Service Code
|
HCPCS 24077
|
| Min. Negotiated Rate |
$738.80 |
| Max. Negotiated Rate |
$1,428.90 |
| Rate for Payer: Aetna Commercial |
$1,329.67
|
| Rate for Payer: Aetna Medicare |
$1,031.98
|
| Rate for Payer: BCBS Complete |
$738.80
|
| Rate for Payer: BCBS MAPPO |
$992.29
|
| Rate for Payer: BCN Medicare Advantage |
$992.29
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cash Price |
$1,477.60
|
| Rate for Payer: Cofinity Commercial |
$1,428.90
|
| Rate for Payer: Cofinity Commercial |
$1,329.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.90
|
| Rate for Payer: Nomi Health Commercial |
$1,190.75
|
| Rate for Payer: PACE SWMI |
$992.29
|
| Rate for Payer: PHP Medicare Advantage |
$992.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.55
|
| Rate for Payer: Priority Health Medicare |
$1,002.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$992.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.29
|
| Rate for Payer: UHC Exchange |
$992.29
|
| Rate for Payer: UHC Medicare Advantage |
$992.29
|
|
|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW 5CM+
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 24079
|
| Min. Negotiated Rate |
$1,246.80 |
| Max. Negotiated Rate |
$2,026.05 |
| Rate for Payer: Aetna Commercial |
$1,720.75
|
| Rate for Payer: Aetna Medicare |
$1,335.51
|
| Rate for Payer: BCBS Complete |
$1,246.80
|
| Rate for Payer: BCBS MAPPO |
$1,284.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,284.14
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,849.16
|
| Rate for Payer: Cofinity Commercial |
$1,720.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,284.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,348.35
|
| Rate for Payer: Nomi Health Commercial |
$1,540.97
|
| Rate for Payer: PACE SWMI |
$1,284.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,284.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health Medicare |
$1,296.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,284.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,284.14
|
| Rate for Payer: UHC Exchange |
$1,284.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,284.14
|
|
|
PR RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>
|
Professional
|
Both
|
$3,940.00
|
|
|
Service Code
|
HCPCS 25078
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$2,561.00 |
| Rate for Payer: Aetna Commercial |
$1,512.06
|
| Rate for Payer: Aetna Medicare |
$1,173.54
|
| Rate for Payer: BCBS Complete |
$1,576.00
|
| Rate for Payer: BCBS MAPPO |
$1,128.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.40
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,624.90
|
| Rate for Payer: Cofinity Commercial |
$1,512.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.82
|
| Rate for Payer: Nomi Health Commercial |
$1,354.08
|
| Rate for Payer: PACE SWMI |
$1,128.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,561.00
|
| Rate for Payer: Priority Health Medicare |
$1,139.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,128.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.40
|
| Rate for Payer: UHC Exchange |
$1,128.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.40
|
|
|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 26118
|
| Min. Negotiated Rate |
$1,015.82 |
| Max. Negotiated Rate |
$2,280.85 |
| Rate for Payer: Aetna Commercial |
$1,361.20
|
| Rate for Payer: Aetna Medicare |
$1,056.45
|
| Rate for Payer: BCBS Complete |
$1,403.60
|
| Rate for Payer: BCBS MAPPO |
$1,015.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.82
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cofinity Commercial |
$1,462.78
|
| Rate for Payer: Cofinity Commercial |
$1,361.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.61
|
| Rate for Payer: Nomi Health Commercial |
$1,218.98
|
| Rate for Payer: PACE SWMI |
$1,015.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,280.85
|
| Rate for Payer: Priority Health Medicare |
$1,025.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,015.82
|
| Rate for Payer: UHC Exchange |
$1,015.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.82
|
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$4,271.00
|
|
|
Service Code
|
HCPCS 27075
|
| Min. Negotiated Rate |
$1,708.40 |
| Max. Negotiated Rate |
$2,884.19 |
| Rate for Payer: Aetna Commercial |
$2,683.90
|
| Rate for Payer: Aetna Medicare |
$2,083.03
|
| Rate for Payer: BCBS Complete |
$1,708.40
|
| Rate for Payer: BCBS MAPPO |
$2,002.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,002.91
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cofinity Commercial |
$2,884.19
|
| Rate for Payer: Cofinity Commercial |
$2,683.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,002.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,103.06
|
| Rate for Payer: Nomi Health Commercial |
$2,403.49
|
| Rate for Payer: PACE SWMI |
$2,002.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,002.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.15
|
| Rate for Payer: Priority Health Medicare |
$2,022.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,002.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,002.91
|
| Rate for Payer: UHC Exchange |
$2,002.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,002.91
|
|
|
PR RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,646.00
|
|
|
Service Code
|
HCPCS 26260
|
| Min. Negotiated Rate |
$658.40 |
| Max. Negotiated Rate |
$1,109.89 |
| Rate for Payer: Aetna Commercial |
$1,032.82
|
| Rate for Payer: Aetna Medicare |
$801.59
|
| Rate for Payer: BCBS Complete |
$658.40
|
| Rate for Payer: BCBS MAPPO |
$770.76
|
| Rate for Payer: BCN Medicare Advantage |
$770.76
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cofinity Commercial |
$1,109.89
|
| Rate for Payer: Cofinity Commercial |
$1,032.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.30
|
| Rate for Payer: Nomi Health Commercial |
$924.91
|
| Rate for Payer: PACE SWMI |
$770.76
|
| Rate for Payer: PHP Medicare Advantage |
$770.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.90
|
| Rate for Payer: Priority Health Medicare |
$778.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.76
|
| Rate for Payer: UHC Exchange |
$770.76
|
| Rate for Payer: UHC Medicare Advantage |
$770.76
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>
|
Professional
|
Both
|
$1,757.00
|
|
|
Service Code
|
HCPCS 21016
|
| Min. Negotiated Rate |
$702.80 |
| Max. Negotiated Rate |
$1,388.45 |
| Rate for Payer: Aetna Commercial |
$1,292.03
|
| Rate for Payer: Aetna Medicare |
$1,002.77
|
| Rate for Payer: BCBS Complete |
$702.80
|
| Rate for Payer: BCBS MAPPO |
$964.20
|
| Rate for Payer: BCN Medicare Advantage |
$964.20
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cofinity Commercial |
$1,388.45
|
| Rate for Payer: Cofinity Commercial |
$1,292.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.41
|
| Rate for Payer: Nomi Health Commercial |
$1,157.04
|
| Rate for Payer: PACE SWMI |
$964.20
|
| Rate for Payer: PHP Medicare Advantage |
$964.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.05
|
| Rate for Payer: Priority Health Medicare |
$973.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.20
|
| Rate for Payer: UHC Exchange |
$964.20
|
| Rate for Payer: UHC Medicare Advantage |
$964.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 21015
|
| Min. Negotiated Rate |
$358.40 |
| Max. Negotiated Rate |
$964.43 |
| Rate for Payer: Aetna Commercial |
$897.45
|
| Rate for Payer: Aetna Medicare |
$696.53
|
| Rate for Payer: BCBS Complete |
$358.40
|
| Rate for Payer: BCBS MAPPO |
$669.74
|
| Rate for Payer: BCN Medicare Advantage |
$669.74
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$964.43
|
| Rate for Payer: Cofinity Commercial |
$897.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.23
|
| Rate for Payer: Nomi Health Commercial |
$803.69
|
| Rate for Payer: PACE SWMI |
$669.74
|
| Rate for Payer: PHP Medicare Advantage |
$669.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.40
|
| Rate for Payer: Priority Health Medicare |
$676.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$669.74
|
| Rate for Payer: UHC Exchange |
$669.74
|
| Rate for Payer: UHC Medicare Advantage |
$669.74
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$2,420.00
|
|
|
Service Code
|
HCPCS 22905
|
| Min. Negotiated Rate |
$968.00 |
| Max. Negotiated Rate |
$1,860.48 |
| Rate for Payer: Aetna Commercial |
$1,731.28
|
| Rate for Payer: Aetna Medicare |
$1,343.68
|
| Rate for Payer: BCBS Complete |
$968.00
|
| Rate for Payer: BCBS MAPPO |
$1,292.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,292.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cofinity Commercial |
$1,860.48
|
| Rate for Payer: Cofinity Commercial |
$1,731.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,292.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,356.60
|
| Rate for Payer: Nomi Health Commercial |
$1,550.40
|
| Rate for Payer: PACE SWMI |
$1,292.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,292.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,573.00
|
| Rate for Payer: Priority Health Medicare |
$1,304.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,292.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,292.00
|
| Rate for Payer: UHC Exchange |
$1,292.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,292.00
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM
|
Professional
|
Both
|
$2,134.00
|
|
|
Service Code
|
HCPCS 22904
|
| Min. Negotiated Rate |
$853.60 |
| Max. Negotiated Rate |
$1,454.69 |
| Rate for Payer: Aetna Commercial |
$1,353.67
|
| Rate for Payer: Aetna Medicare |
$1,050.61
|
| Rate for Payer: BCBS Complete |
$853.60
|
| Rate for Payer: BCBS MAPPO |
$1,010.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,010.20
|
| Rate for Payer: Cash Price |
$1,707.20
|
| Rate for Payer: Cash Price |
$1,707.20
|
| Rate for Payer: Cofinity Commercial |
$1,454.69
|
| Rate for Payer: Cofinity Commercial |
$1,353.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,010.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,060.71
|
| Rate for Payer: Nomi Health Commercial |
$1,212.24
|
| Rate for Payer: PACE SWMI |
$1,010.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,010.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,387.10
|
| Rate for Payer: Priority Health Medicare |
$1,020.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,010.20
|
| Rate for Payer: UHC Exchange |
$1,010.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,010.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM
|
Professional
|
Both
|
$2,940.00
|
|
|
Service Code
|
HCPCS 21935
|
| Min. Negotiated Rate |
$984.68 |
| Max. Negotiated Rate |
$1,911.00 |
| Rate for Payer: Aetna Commercial |
$1,319.47
|
| Rate for Payer: Aetna Medicare |
$1,024.07
|
| Rate for Payer: BCBS Complete |
$1,176.00
|
| Rate for Payer: BCBS MAPPO |
$984.68
|
| Rate for Payer: BCN Medicare Advantage |
$984.68
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,319.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,033.91
|
| Rate for Payer: Nomi Health Commercial |
$1,181.62
|
| Rate for Payer: PACE SWMI |
$984.68
|
| Rate for Payer: PHP Medicare Advantage |
$984.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,911.00
|
| Rate for Payer: Priority Health Medicare |
$994.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.68
|
| Rate for Payer: UHC Exchange |
$984.68
|
| Rate for Payer: UHC Medicare Advantage |
$984.68
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>
|
Professional
|
Both
|
$2,598.00
|
|
|
Service Code
|
HCPCS 21936
|
| Min. Negotiated Rate |
$1,039.20 |
| Max. Negotiated Rate |
$1,969.53 |
| Rate for Payer: Aetna Commercial |
$1,832.76
|
| Rate for Payer: Aetna Medicare |
$1,422.44
|
| Rate for Payer: BCBS Complete |
$1,039.20
|
| Rate for Payer: BCBS MAPPO |
$1,367.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,367.73
|
| Rate for Payer: Cash Price |
$2,078.40
|
| Rate for Payer: Cash Price |
$2,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,969.53
|
| Rate for Payer: Cofinity Commercial |
$1,832.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,367.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,436.12
|
| Rate for Payer: Nomi Health Commercial |
$1,641.28
|
| Rate for Payer: PACE SWMI |
$1,367.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,367.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,688.70
|
| Rate for Payer: Priority Health Medicare |
$1,381.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,367.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,367.73
|
| Rate for Payer: UHC Exchange |
$1,367.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,367.73
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 27616
|
| Min. Negotiated Rate |
$925.20 |
| Max. Negotiated Rate |
$1,734.42 |
| Rate for Payer: Aetna Commercial |
$1,613.98
|
| Rate for Payer: Aetna Medicare |
$1,252.64
|
| Rate for Payer: BCBS Complete |
$925.20
|
| Rate for Payer: BCBS MAPPO |
$1,204.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,204.46
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$1,734.42
|
| Rate for Payer: Cofinity Commercial |
$1,613.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,204.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,264.68
|
| Rate for Payer: Nomi Health Commercial |
$1,445.35
|
| Rate for Payer: PACE SWMI |
$1,204.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,204.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health Medicare |
$1,216.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,204.46
|
| Rate for Payer: UHC Exchange |
$1,204.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,204.46
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 23077
|
| Min. Negotiated Rate |
$820.40 |
| Max. Negotiated Rate |
$1,577.92 |
| Rate for Payer: Aetna Commercial |
$1,468.35
|
| Rate for Payer: Aetna Medicare |
$1,139.61
|
| Rate for Payer: BCBS Complete |
$820.40
|
| Rate for Payer: BCBS MAPPO |
$1,095.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,095.78
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,577.92
|
| Rate for Payer: Cofinity Commercial |
$1,468.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,095.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.57
|
| Rate for Payer: Nomi Health Commercial |
$1,314.94
|
| Rate for Payer: PACE SWMI |
$1,095.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,095.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.15
|
| Rate for Payer: Priority Health Medicare |
$1,106.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,095.78
|
| Rate for Payer: UHC Exchange |
$1,095.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.78
|
|
|
PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>
|
Professional
|
Both
|
$6,657.00
|
|
|
Service Code
|
HCPCS 27364
|
| Min. Negotiated Rate |
$1,512.06 |
| Max. Negotiated Rate |
$4,327.05 |
| Rate for Payer: Aetna Commercial |
$2,026.16
|
| Rate for Payer: Aetna Medicare |
$1,572.54
|
| Rate for Payer: BCBS Complete |
$2,662.80
|
| Rate for Payer: BCBS MAPPO |
$1,512.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,512.06
|
| Rate for Payer: Cash Price |
$5,325.60
|
| Rate for Payer: Cash Price |
$5,325.60
|
| Rate for Payer: Cofinity Commercial |
$2,177.37
|
| Rate for Payer: Cofinity Commercial |
$2,026.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,512.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,587.66
|
| Rate for Payer: Nomi Health Commercial |
$1,814.47
|
| Rate for Payer: PACE SWMI |
$1,512.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,512.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,327.05
|
| Rate for Payer: Priority Health Medicare |
$1,527.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,512.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,512.06
|
| Rate for Payer: UHC Exchange |
$1,512.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,512.06
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 25077
|
| Min. Negotiated Rate |
$835.39 |
| Max. Negotiated Rate |
$1,869.40 |
| Rate for Payer: Aetna Commercial |
$1,119.42
|
| Rate for Payer: Aetna Medicare |
$868.81
|
| Rate for Payer: BCBS Complete |
$1,150.40
|
| Rate for Payer: BCBS MAPPO |
$835.39
|
| Rate for Payer: BCN Medicare Advantage |
$835.39
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,202.96
|
| Rate for Payer: Cofinity Commercial |
$1,119.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.16
|
| Rate for Payer: Nomi Health Commercial |
$1,002.47
|
| Rate for Payer: PACE SWMI |
$835.39
|
| Rate for Payer: PHP Medicare Advantage |
$835.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health Medicare |
$843.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.39
|
| Rate for Payer: UHC Exchange |
$835.39
|
| Rate for Payer: UHC Medicare Advantage |
$835.39
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
IP
|
$2,876.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,869.40 |
| Max. Negotiated Rate |
$2,588.40 |
| Rate for Payer: Aetna Commercial |
$2,444.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,347.68
|
| Rate for Payer: BCN Commercial |
$2,222.57
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$2,473.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,300.80
|
| Rate for Payer: Healthscope Commercial |
$2,588.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,157.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,444.60
|
| Rate for Payer: Nomi Health Commercial |
$2,358.32
|
| Rate for Payer: PHP Commercial |
$2,444.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,502.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,926.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,530.88
|
| Rate for Payer: UHC Core |
$2,401.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,157.00
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
OP
|
$2,876.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$683.05 |
| Max. Negotiated Rate |
$2,588.40 |
| Rate for Payer: Aetna Commercial |
$2,444.60
|
| Rate for Payer: Aetna Medicare |
$747.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$898.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$898.75
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$719.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,364.36
|
| Rate for Payer: BCN Commercial |
$2,236.09
|
| Rate for Payer: BCN Medicare Advantage |
$719.00
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$2,473.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,300.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.00
|
| Rate for Payer: Healthscope Commercial |
$2,588.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,157.00
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$754.95
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$826.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,444.60
|
| Rate for Payer: Nomi Health Commercial |
$2,358.32
|
| Rate for Payer: PACE Senior Care Partners |
$683.05
|
| Rate for Payer: PACE SWMI |
$719.00
|
| Rate for Payer: PHP Commercial |
$2,444.60
|
| Rate for Payer: PHP Medicare Advantage |
$719.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,502.12
|
| Rate for Payer: Priority Health Medicare |
$726.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,926.92
|
| Rate for Payer: Railroad Medicare Medicare |
$719.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,530.88
|
| Rate for Payer: UHC Core |
$2,401.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.00
|
| Rate for Payer: UHC Exchange |
$719.00
|
| Rate for Payer: UHC Medicare Advantage |
$719.00
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$719.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,157.00
|
|
