|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Facility
|
IP
|
$1,239.00
|
|
|
Service Code
|
CPT 22901
|
| Hospital Charge Code |
22901
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$545.16 |
| Max. Negotiated Rate |
$1,115.10 |
| Rate for Payer: Aetna American Axle |
$805.35
|
| Rate for Payer: Aetna Commercial |
$1,053.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.35
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Advantage |
$867.30
|
| Rate for Payer: Cofinity Commercial |
$1,065.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.20
|
| Rate for Payer: Healthscope Commercial |
$1,115.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$867.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PHP Commercial |
$1,053.15
|
| Rate for Payer: Priority Health SBD |
$780.57
|
| Rate for Payer: UMR Bronson Commercial |
$545.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,178.07 |
| Rate for Payer: Aetna Commercial |
$847.26
|
| Rate for Payer: Aetna Medicare |
$657.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$847.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$910.48
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$632.28
|
| Rate for Payer: BCN Commercial |
$1,011.40
|
| Rate for Payer: BCN Medicare Advantage |
$632.28
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$847.26
|
| Rate for Payer: Cofinity Commercial |
$910.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.89
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$695.51
|
| Rate for Payer: Nomi Health Commercial |
$758.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PACE SWMI |
$632.28
|
| Rate for Payer: PHP Commercial |
$885.19
|
| Rate for Payer: PHP Medicare Advantage |
$632.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,081.16
|
| Rate for Payer: Priority Health Medicare |
$632.28
|
| Rate for Payer: Priority Health SBD |
$1,081.16
|
| Rate for Payer: Priority Health Tiered Network |
$1,081.16
|
| Rate for Payer: Railroad Medicare Medicare |
$632.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,178.07
|
| Rate for Payer: UHC Core |
$1,178.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$632.28
|
| Rate for Payer: UHC Exchange |
$1,178.07
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
| Rate for Payer: UMR Bronson Commercial |
$569.94
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$735.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$323.40 |
| Max. Negotiated Rate |
$661.50 |
| Rate for Payer: Aetna American Axle |
$477.75
|
| Rate for Payer: Aetna Commercial |
$624.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.75
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Advantage |
$514.50
|
| Rate for Payer: Cofinity Commercial |
$632.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.00
|
| Rate for Payer: Healthscope Commercial |
$661.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$514.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PHP Commercial |
$624.75
|
| Rate for Payer: Priority Health SBD |
$463.05
|
| Rate for Payer: UMR Bronson Commercial |
$323.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$772.73 |
| Rate for Payer: Aetna Commercial |
$564.02
|
| Rate for Payer: Aetna Medicare |
$437.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.11
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS MAPPO |
$420.91
|
| Rate for Payer: BCN Commercial |
$670.28
|
| Rate for Payer: BCN Medicare Advantage |
$420.91
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$564.02
|
| Rate for Payer: Cofinity Commercial |
$606.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.96
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.00
|
| Rate for Payer: Nomi Health Commercial |
$505.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$420.91
|
| Rate for Payer: PHP Commercial |
$589.27
|
| Rate for Payer: PHP Medicare Advantage |
$420.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$716.51
|
| Rate for Payer: Priority Health Medicare |
$420.91
|
| Rate for Payer: Priority Health SBD |
$716.51
|
| Rate for Payer: Priority Health Tiered Network |
$716.51
|
| Rate for Payer: Railroad Medicare Medicare |
$420.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.73
|
| Rate for Payer: UHC Core |
$772.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.91
|
| Rate for Payer: UHC Exchange |
$772.73
|
| Rate for Payer: UHC Medicaid |
$273.49
|
| Rate for Payer: UHCCP Medicaid |
$273.49
|
| Rate for Payer: UMR Bronson Commercial |
$338.10
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$772.73 |
| Rate for Payer: Aetna Commercial |
$564.02
|
| Rate for Payer: Aetna Medicare |
$437.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.11
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS MAPPO |
$420.91
|
| Rate for Payer: BCN Commercial |
$670.28
|
| Rate for Payer: BCN Medicare Advantage |
$420.91
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$564.02
|
| Rate for Payer: Cofinity Commercial |
$606.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.96
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.00
|
| Rate for Payer: Nomi Health Commercial |
$505.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$420.91
|
| Rate for Payer: PHP Commercial |
$589.27
|
| Rate for Payer: PHP Medicare Advantage |
$420.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$716.51
|
| Rate for Payer: Priority Health Medicare |
$420.91
|
| Rate for Payer: Priority Health SBD |
$716.51
|
| Rate for Payer: Priority Health Tiered Network |
$716.51
|
| Rate for Payer: Railroad Medicare Medicare |
$420.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.73
|
| Rate for Payer: UHC Core |
$772.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.91
|
| Rate for Payer: UHC Exchange |
$772.73
|
| Rate for Payer: UHC Medicaid |
$273.49
|
| Rate for Payer: UHCCP Medicaid |
$273.49
|
| Rate for Payer: UMR Bronson Commercial |
$338.10
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$735.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$271.95 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$477.75
|
| Rate for Payer: Aetna Commercial |
$624.75
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,199.51
|
| Rate for Payer: BCN Commercial |
$3,199.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Advantage |
$514.50
|
| Rate for Payer: Cofinity Commercial |
$632.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$661.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$514.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.25
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.75
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$624.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$463.05
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$271.95
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$211.30 |
| Max. Negotiated Rate |
$611.25 |
| Rate for Payer: Aetna Commercial |
$432.49
|
| Rate for Payer: Aetna Medicare |
$335.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.76
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCBS MAPPO |
$322.75
|
| Rate for Payer: BCN Commercial |
$509.93
|
| Rate for Payer: BCN Medicare Advantage |
$322.75
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cofinity Commercial |
$432.49
|
| Rate for Payer: Cofinity Commercial |
$464.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.89
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.02
|
| Rate for Payer: Nomi Health Commercial |
$387.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$611.25
|
| Rate for Payer: PACE SWMI |
$322.75
|
| Rate for Payer: PHP Commercial |
$451.85
|
| Rate for Payer: PHP Medicare Advantage |
$322.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$545.11
|
| Rate for Payer: Priority Health Medicare |
$322.75
|
| Rate for Payer: Priority Health SBD |
$545.11
|
| Rate for Payer: Priority Health Tiered Network |
$545.11
|
| Rate for Payer: Railroad Medicare Medicare |
$322.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.79
|
| Rate for Payer: UHC Core |
$578.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$322.75
|
| Rate for Payer: UHC Exchange |
$578.79
|
| Rate for Payer: UHC Medicaid |
$211.30
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
| Rate for Payer: UMR Bronson Commercial |
$374.90
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,242.00
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$931.50 |
| Rate for Payer: Aetna Commercial |
$550.38
|
| Rate for Payer: Aetna Medicare |
$427.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$591.45
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$410.73
|
| Rate for Payer: BCN Commercial |
$682.23
|
| Rate for Payer: BCN Medicare Advantage |
$410.73
|
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cofinity Commercial |
$550.38
|
| Rate for Payer: Cofinity Commercial |
$591.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.27
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$451.80
|
| Rate for Payer: Nomi Health Commercial |
$492.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$931.50
|
| Rate for Payer: PACE SWMI |
$410.73
|
| Rate for Payer: PHP Commercial |
$575.02
|
| Rate for Payer: PHP Medicare Advantage |
$410.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$729.29
|
| Rate for Payer: Priority Health Medicare |
$410.73
|
| Rate for Payer: Priority Health SBD |
$729.29
|
| Rate for Payer: Priority Health Tiered Network |
$729.29
|
| Rate for Payer: Railroad Medicare Medicare |
$410.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.30
|
| Rate for Payer: UHC Core |
$793.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$410.73
|
| Rate for Payer: UHC Exchange |
$793.30
|
| Rate for Payer: UHC Medicaid |
$268.59
|
| Rate for Payer: UHCCP Medicaid |
$268.59
|
| Rate for Payer: UMR Bronson Commercial |
$571.32
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$907.00
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$680.25 |
| Rate for Payer: Aetna Commercial |
$428.81
|
| Rate for Payer: Aetna Medicare |
$332.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$428.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$460.81
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$320.01
|
| Rate for Payer: BCN Commercial |
$530.35
|
| Rate for Payer: BCN Medicare Advantage |
$320.01
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cofinity Commercial |
$428.81
|
| Rate for Payer: Cofinity Commercial |
$460.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.01
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.01
|
| Rate for Payer: Nomi Health Commercial |
$384.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.25
|
| Rate for Payer: PACE SWMI |
$320.01
|
| Rate for Payer: PHP Commercial |
$448.01
|
| Rate for Payer: PHP Medicare Advantage |
$320.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$566.93
|
| Rate for Payer: Priority Health Medicare |
$320.01
|
| Rate for Payer: Priority Health SBD |
$566.93
|
| Rate for Payer: Priority Health Tiered Network |
$566.93
|
| Rate for Payer: Railroad Medicare Medicare |
$320.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.63
|
| Rate for Payer: UHC Core |
$604.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$320.01
|
| Rate for Payer: UHC Exchange |
$604.63
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
| Rate for Payer: UMR Bronson Commercial |
$417.22
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
IP
|
$1,210.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$532.40 |
| Max. Negotiated Rate |
$1,089.00 |
| Rate for Payer: Aetna American Axle |
$786.50
|
| Rate for Payer: Aetna Commercial |
$1,028.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.50
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Advantage |
$847.00
|
| Rate for Payer: Cofinity Commercial |
$1,040.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.00
|
| Rate for Payer: Healthscope Commercial |
$1,089.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$847.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PHP Commercial |
$1,028.50
|
| Rate for Payer: Priority Health SBD |
$762.30
|
| Rate for Payer: UMR Bronson Commercial |
$532.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
OP
|
$1,210.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$447.70 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$786.50
|
| Rate for Payer: Aetna Commercial |
$1,028.50
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,431.72
|
| Rate for Payer: BCN Commercial |
$2,431.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Advantage |
$847.00
|
| Rate for Payer: Cofinity Commercial |
$1,040.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,089.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$847.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.50
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.50
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,028.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$762.30
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$447.70
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 25075
|
| Hospital Charge Code |
25075
|
| Min. Negotiated Rate |
$195.53 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Aetna Commercial |
$397.98
|
| Rate for Payer: Aetna Medicare |
$308.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.68
|
| Rate for Payer: BCBS Complete |
$205.31
|
| Rate for Payer: BCBS MAPPO |
$297.00
|
| Rate for Payer: BCN Commercial |
$485.54
|
| Rate for Payer: BCN Medicare Advantage |
$297.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$397.98
|
| Rate for Payer: Cofinity Commercial |
$427.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.85
|
| Rate for Payer: Meridian Medicaid |
$205.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.70
|
| Rate for Payer: Nomi Health Commercial |
$356.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PACE SWMI |
$297.00
|
| Rate for Payer: PHP Commercial |
$415.80
|
| Rate for Payer: PHP Medicare Advantage |
$297.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$519.02
|
| Rate for Payer: Priority Health Medicare |
$297.00
|
| Rate for Payer: Priority Health SBD |
$519.02
|
| Rate for Payer: Priority Health Tiered Network |
$519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$297.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.60
|
| Rate for Payer: UHC Core |
$547.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.00
|
| Rate for Payer: UHC Exchange |
$547.60
|
| Rate for Payer: UHC Medicaid |
$195.53
|
| Rate for Payer: UHCCP Medicaid |
$195.53
|
| Rate for Payer: UMR Bronson Commercial |
$556.60
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$195.53 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Aetna Commercial |
$397.98
|
| Rate for Payer: Aetna Medicare |
$308.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.68
|
| Rate for Payer: BCBS Complete |
$205.31
|
| Rate for Payer: BCBS MAPPO |
$297.00
|
| Rate for Payer: BCN Commercial |
$485.54
|
| Rate for Payer: BCN Medicare Advantage |
$297.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$397.98
|
| Rate for Payer: Cofinity Commercial |
$427.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.85
|
| Rate for Payer: Meridian Medicaid |
$205.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.70
|
| Rate for Payer: Nomi Health Commercial |
$356.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PACE SWMI |
$297.00
|
| Rate for Payer: PHP Commercial |
$415.80
|
| Rate for Payer: PHP Medicare Advantage |
$297.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$519.02
|
| Rate for Payer: Priority Health Medicare |
$297.00
|
| Rate for Payer: Priority Health SBD |
$519.02
|
| Rate for Payer: Priority Health Tiered Network |
$519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$297.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.60
|
| Rate for Payer: UHC Core |
$547.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.00
|
| Rate for Payer: UHC Exchange |
$547.60
|
| Rate for Payer: UHC Medicaid |
$195.53
|
| Rate for Payer: UHCCP Medicaid |
$195.53
|
| Rate for Payer: UMR Bronson Commercial |
$556.60
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 27634
|
| Min. Negotiated Rate |
$397.46 |
| Max. Negotiated Rate |
$1,842.75 |
| Rate for Payer: Aetna Commercial |
$819.54
|
| Rate for Payer: Aetna Medicare |
$636.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$819.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$880.70
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$611.60
|
| Rate for Payer: BCN Commercial |
$1,016.38
|
| Rate for Payer: BCN Medicare Advantage |
$611.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cofinity Commercial |
$819.54
|
| Rate for Payer: Cofinity Commercial |
$880.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$611.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.18
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$672.76
|
| Rate for Payer: Nomi Health Commercial |
$733.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,842.75
|
| Rate for Payer: PACE SWMI |
$611.60
|
| Rate for Payer: PHP Commercial |
$856.24
|
| Rate for Payer: PHP Medicare Advantage |
$611.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,086.48
|
| Rate for Payer: Priority Health Medicare |
$611.60
|
| Rate for Payer: Priority Health SBD |
$1,086.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,086.48
|
| Rate for Payer: Railroad Medicare Medicare |
$611.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.22
|
| Rate for Payer: UHC Core |
$1,198.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$611.60
|
| Rate for Payer: UHC Exchange |
$1,198.22
|
| Rate for Payer: UHC Medicaid |
$397.46
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,130.22
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$278.18 |
| Max. Negotiated Rate |
$963.00 |
| Rate for Payer: Aetna Commercial |
$570.84
|
| Rate for Payer: Aetna Medicare |
$443.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.44
|
| Rate for Payer: BCBS Complete |
$292.09
|
| Rate for Payer: BCBS MAPPO |
$426.00
|
| Rate for Payer: BCN Commercial |
$709.63
|
| Rate for Payer: BCN Medicare Advantage |
$426.00
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cofinity Commercial |
$570.84
|
| Rate for Payer: Cofinity Commercial |
$613.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.30
|
| Rate for Payer: Meridian Medicaid |
$292.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.60
|
| Rate for Payer: Nomi Health Commercial |
$511.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.00
|
| Rate for Payer: PACE SWMI |
$426.00
|
| Rate for Payer: PHP Commercial |
$596.40
|
| Rate for Payer: PHP Medicare Advantage |
$426.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$758.57
|
| Rate for Payer: Priority Health Medicare |
$426.00
|
| Rate for Payer: Priority Health SBD |
$758.57
|
| Rate for Payer: Priority Health Tiered Network |
$758.57
|
| Rate for Payer: Railroad Medicare Medicare |
$426.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$807.19
|
| Rate for Payer: UHC Core |
$807.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.00
|
| Rate for Payer: UHC Exchange |
$807.19
|
| Rate for Payer: UHC Medicaid |
$278.18
|
| Rate for Payer: UHCCP Medicaid |
$278.18
|
| Rate for Payer: UMR Bronson Commercial |
$590.64
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,117.00
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$190.21 |
| Max. Negotiated Rate |
$837.75 |
| Rate for Payer: Aetna Commercial |
$387.47
|
| Rate for Payer: Aetna Medicare |
$300.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.39
|
| Rate for Payer: BCBS Complete |
$199.72
|
| Rate for Payer: BCBS MAPPO |
$289.16
|
| Rate for Payer: BCN Commercial |
$467.11
|
| Rate for Payer: BCN Medicare Advantage |
$289.16
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cofinity Commercial |
$387.47
|
| Rate for Payer: Cofinity Commercial |
$416.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.62
|
| Rate for Payer: Meridian Medicaid |
$199.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.08
|
| Rate for Payer: Nomi Health Commercial |
$346.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$837.75
|
| Rate for Payer: PACE SWMI |
$289.16
|
| Rate for Payer: PHP Commercial |
$404.82
|
| Rate for Payer: PHP Medicare Advantage |
$289.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$499.32
|
| Rate for Payer: Priority Health Medicare |
$289.16
|
| Rate for Payer: Priority Health SBD |
$499.32
|
| Rate for Payer: Priority Health Tiered Network |
$499.32
|
| Rate for Payer: Railroad Medicare Medicare |
$289.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.62
|
| Rate for Payer: UHC Core |
$529.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$289.16
|
| Rate for Payer: UHC Exchange |
$529.62
|
| Rate for Payer: UHC Medicaid |
$190.21
|
| Rate for Payer: UHCCP Medicaid |
$190.21
|
| Rate for Payer: UMR Bronson Commercial |
$513.82
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Aetna Commercial |
$387.05
|
| Rate for Payer: Aetna Medicare |
$300.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.93
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$288.84
|
| Rate for Payer: BCN Commercial |
$469.10
|
| Rate for Payer: BCN Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$387.05
|
| Rate for Payer: Cofinity Commercial |
$415.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.28
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.72
|
| Rate for Payer: Nomi Health Commercial |
$346.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE SWMI |
$288.84
|
| Rate for Payer: PHP Commercial |
$404.38
|
| Rate for Payer: PHP Medicare Advantage |
$288.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$501.45
|
| Rate for Payer: Priority Health Medicare |
$288.84
|
| Rate for Payer: Priority Health SBD |
$501.45
|
| Rate for Payer: Priority Health Tiered Network |
$501.45
|
| Rate for Payer: Railroad Medicare Medicare |
$288.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.37
|
| Rate for Payer: UHC Core |
$530.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.84
|
| Rate for Payer: UHC Exchange |
$530.37
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
| Rate for Payer: UMR Bronson Commercial |
$381.80
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$830.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$365.20 |
| Max. Negotiated Rate |
$747.00 |
| Rate for Payer: Aetna American Axle |
$539.50
|
| Rate for Payer: Aetna Commercial |
$705.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.50
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Advantage |
$581.00
|
| Rate for Payer: Cofinity Commercial |
$713.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$664.00
|
| Rate for Payer: Healthscope Commercial |
$747.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$581.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PHP Commercial |
$705.50
|
| Rate for Payer: Priority Health SBD |
$522.90
|
| Rate for Payer: UMR Bronson Commercial |
$365.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$830.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$307.10 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$539.50
|
| Rate for Payer: Aetna Commercial |
$705.50
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,057.37
|
| Rate for Payer: BCN Commercial |
$3,057.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Advantage |
$581.00
|
| Rate for Payer: Cofinity Commercial |
$713.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$664.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$747.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$581.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.50
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.50
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$705.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$522.90
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$307.10
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Aetna Commercial |
$387.05
|
| Rate for Payer: Aetna Medicare |
$300.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.93
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$288.84
|
| Rate for Payer: BCN Commercial |
$469.10
|
| Rate for Payer: BCN Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$387.05
|
| Rate for Payer: Cofinity Commercial |
$415.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.28
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.72
|
| Rate for Payer: Nomi Health Commercial |
$346.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE SWMI |
$288.84
|
| Rate for Payer: PHP Commercial |
$404.38
|
| Rate for Payer: PHP Medicare Advantage |
$288.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$501.45
|
| Rate for Payer: Priority Health Medicare |
$288.84
|
| Rate for Payer: Priority Health SBD |
$501.45
|
| Rate for Payer: Priority Health Tiered Network |
$501.45
|
| Rate for Payer: Railroad Medicare Medicare |
$288.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.37
|
| Rate for Payer: UHC Core |
$530.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.84
|
| Rate for Payer: UHC Exchange |
$530.37
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
| Rate for Payer: UMR Bronson Commercial |
$381.80
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
OP
|
$2,208.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$816.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$1,435.20
|
| Rate for Payer: Aetna Commercial |
$1,876.80
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$4,032.47
|
| Rate for Payer: BCN Commercial |
$4,032.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Advantage |
$1,545.60
|
| Rate for Payer: Cofinity Commercial |
$1,898.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,987.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,545.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,656.00
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,876.80
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$1,876.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$1,391.04
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$816.96
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,656.00
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
IP
|
$2,208.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$971.52 |
| Max. Negotiated Rate |
$1,987.20 |
| Rate for Payer: Aetna American Axle |
$1,435.20
|
| Rate for Payer: Aetna Commercial |
$1,876.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.20
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Advantage |
$1,545.60
|
| Rate for Payer: Cofinity Commercial |
$1,898.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.40
|
| Rate for Payer: Healthscope Commercial |
$1,987.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,545.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,656.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,876.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| Rate for Payer: PHP Commercial |
$1,876.80
|
| Rate for Payer: Priority Health SBD |
$1,391.04
|
| Rate for Payer: UMR Bronson Commercial |
$971.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,656.00
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,208.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$434.09 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna Commercial |
$898.15
|
| Rate for Payer: Aetna Medicare |
$697.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.17
|
| Rate for Payer: BCBS Complete |
$455.79
|
| Rate for Payer: BCBS MAPPO |
$670.26
|
| Rate for Payer: BCN Commercial |
$1,107.51
|
| Rate for Payer: BCN Medicare Advantage |
$670.26
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.77
|
| Rate for Payer: Meridian Medicaid |
$455.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$737.29
|
| Rate for Payer: Nomi Health Commercial |
$804.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| Rate for Payer: PACE SWMI |
$670.26
|
| Rate for Payer: PHP Commercial |
$938.36
|
| Rate for Payer: PHP Medicare Advantage |
$670.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.90
|
| Rate for Payer: Priority Health Medicare |
$670.26
|
| Rate for Payer: Priority Health SBD |
$1,183.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,183.90
|
| Rate for Payer: Railroad Medicare Medicare |
$670.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.74
|
| Rate for Payer: UHC Core |
$1,285.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$670.26
|
| Rate for Payer: UHC Exchange |
$1,285.74
|
| Rate for Payer: UHC Medicaid |
$434.09
|
| Rate for Payer: UHCCP Medicaid |
$434.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,015.68
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,208.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$434.09 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna Commercial |
$898.15
|
| Rate for Payer: Aetna Medicare |
$697.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$898.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.17
|
| Rate for Payer: BCBS Complete |
$455.79
|
| Rate for Payer: BCBS MAPPO |
$670.26
|
| Rate for Payer: BCN Commercial |
$1,107.51
|
| Rate for Payer: BCN Medicare Advantage |
$670.26
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.77
|
| Rate for Payer: Meridian Medicaid |
$455.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$737.29
|
| Rate for Payer: Nomi Health Commercial |
$804.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| Rate for Payer: PACE SWMI |
$670.26
|
| Rate for Payer: PHP Commercial |
$938.36
|
| Rate for Payer: PHP Medicare Advantage |
$670.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,183.90
|
| Rate for Payer: Priority Health Medicare |
$670.26
|
| Rate for Payer: Priority Health SBD |
$1,183.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,183.90
|
| Rate for Payer: Railroad Medicare Medicare |
$670.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.74
|
| Rate for Payer: UHC Core |
$1,285.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$670.26
|
| Rate for Payer: UHC Exchange |
$1,285.74
|
| Rate for Payer: UHC Medicaid |
$434.09
|
| Rate for Payer: UHCCP Medicaid |
$434.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,015.68
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$374.24 |
| Max. Negotiated Rate |
$1,069.63 |
| Rate for Payer: Aetna Commercial |
$771.01
|
| Rate for Payer: Aetna Medicare |
$598.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$828.55
|
| Rate for Payer: BCBS Complete |
$392.95
|
| Rate for Payer: BCBS MAPPO |
$575.38
|
| Rate for Payer: BCN Commercial |
$934.71
|
| Rate for Payer: BCN Medicare Advantage |
$575.38
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cofinity Commercial |
$771.01
|
| Rate for Payer: Cofinity Commercial |
$828.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.15
|
| Rate for Payer: Meridian Medicaid |
$392.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$632.92
|
| Rate for Payer: Nomi Health Commercial |
$690.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$980.25
|
| Rate for Payer: PACE SWMI |
$575.38
|
| Rate for Payer: PHP Commercial |
$805.53
|
| Rate for Payer: PHP Medicare Advantage |
$575.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$999.17
|
| Rate for Payer: Priority Health Medicare |
$575.38
|
| Rate for Payer: Priority Health SBD |
$999.17
|
| Rate for Payer: Priority Health Tiered Network |
$999.17
|
| Rate for Payer: Railroad Medicare Medicare |
$575.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.63
|
| Rate for Payer: UHC Core |
$1,069.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$575.38
|
| Rate for Payer: UHC Exchange |
$1,069.63
|
| Rate for Payer: UHC Medicaid |
$374.24
|
| Rate for Payer: UHCCP Medicaid |
$374.24
|
| Rate for Payer: UMR Bronson Commercial |
$601.22
|
|
