|
PR EXC SUBLINGUAL SALIVARY CYST RANULA
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 42408
|
| Min. Negotiated Rate |
$291.20 |
| Max. Negotiated Rate |
$475.93 |
| Rate for Payer: Aetna Commercial |
$442.88
|
| Rate for Payer: Aetna Medicare |
$343.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$475.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.88
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$330.51
|
| Rate for Payer: BCN Medicare Advantage |
$330.51
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$475.93
|
| Rate for Payer: Cofinity Commercial |
$442.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.04
|
| Rate for Payer: Nomi Health Commercial |
$396.61
|
| Rate for Payer: PACE SWMI |
$330.51
|
| Rate for Payer: PHP Commercial |
$462.71
|
| Rate for Payer: PHP Medicare Advantage |
$330.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.20
|
| Rate for Payer: Priority Health Medicare |
$330.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.51
|
| Rate for Payer: UHC Medicare Advantage |
$330.51
|
| Rate for Payer: UMR Bronson Commercial |
$334.88
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$666.74 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$1,171.30
|
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,261.40
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,261.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,261.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$1,135.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$666.74
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Min. Negotiated Rate |
$519.99 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Commercial |
$727.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$519.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,802.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$792.88 |
| Max. Negotiated Rate |
$1,621.80 |
| Rate for Payer: Aetna American Axle |
$1,171.30
|
| Rate for Payer: Aetna Commercial |
$1,531.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,171.30
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$1,261.40
|
| Rate for Payer: Cofinity Commercial |
$1,549.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,261.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,441.60
|
| Rate for Payer: Healthscope Commercial |
$1,621.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,261.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,351.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,531.70
|
| Rate for Payer: PHP Commercial |
$1,531.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health SBD |
$1,135.26
|
| Rate for Payer: UMR Bronson Commercial |
$792.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,351.50
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$519.99 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$696.79
|
| Rate for Payer: Aetna Medicare |
$540.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.79
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$519.99
|
| Rate for Payer: BCN Medicare Advantage |
$519.99
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$748.79
|
| Rate for Payer: Cofinity Commercial |
$696.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.99
|
| Rate for Payer: Nomi Health Commercial |
$623.99
|
| Rate for Payer: PACE SWMI |
$519.99
|
| Rate for Payer: PHP Commercial |
$727.99
|
| Rate for Payer: PHP Medicare Advantage |
$519.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$519.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.99
|
| Rate for Payer: UHC Medicare Advantage |
$519.99
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$108.46 |
| Max. Negotiated Rate |
$230.75 |
| Rate for Payer: Aetna Commercial |
$145.34
|
| Rate for Payer: Aetna Medicare |
$112.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.34
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS MAPPO |
$108.46
|
| Rate for Payer: BCN Medicare Advantage |
$108.46
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$145.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.88
|
| Rate for Payer: Nomi Health Commercial |
$130.15
|
| Rate for Payer: PACE SWMI |
$108.46
|
| Rate for Payer: PHP Commercial |
$151.84
|
| Rate for Payer: PHP Medicare Advantage |
$108.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health Medicare |
$108.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.46
|
| Rate for Payer: UHC Medicare Advantage |
$108.46
|
| Rate for Payer: UMR Bronson Commercial |
$163.30
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,199.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$479.60 |
| Max. Negotiated Rate |
$873.16 |
| Rate for Payer: Aetna Commercial |
$812.52
|
| Rate for Payer: Aetna Medicare |
$630.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$873.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.52
|
| Rate for Payer: BCBS Complete |
$479.60
|
| Rate for Payer: BCBS MAPPO |
$606.36
|
| Rate for Payer: BCN Medicare Advantage |
$606.36
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cash Price |
$959.20
|
| Rate for Payer: Cofinity Commercial |
$873.16
|
| Rate for Payer: Cofinity Commercial |
$812.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.68
|
| Rate for Payer: Nomi Health Commercial |
$727.63
|
| Rate for Payer: PACE SWMI |
$606.36
|
| Rate for Payer: PHP Commercial |
$848.90
|
| Rate for Payer: PHP Medicare Advantage |
$606.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.35
|
| Rate for Payer: Priority Health Medicare |
$606.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.36
|
| Rate for Payer: UHC Medicare Advantage |
$606.36
|
| Rate for Payer: UMR Bronson Commercial |
$551.54
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,995.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$798.00 |
| Max. Negotiated Rate |
$1,606.20 |
| Rate for Payer: Aetna Commercial |
$1,494.66
|
| Rate for Payer: Aetna Medicare |
$1,160.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,606.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.66
|
| Rate for Payer: BCBS Complete |
$798.00
|
| Rate for Payer: BCBS MAPPO |
$1,115.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,115.42
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cash Price |
$1,596.00
|
| Rate for Payer: Cofinity Commercial |
$1,606.20
|
| Rate for Payer: Cofinity Commercial |
$1,494.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,115.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,171.19
|
| Rate for Payer: Nomi Health Commercial |
$1,338.50
|
| Rate for Payer: PACE SWMI |
$1,115.42
|
| Rate for Payer: PHP Commercial |
$1,561.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,115.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.75
|
| Rate for Payer: Priority Health Medicare |
$1,115.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,115.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,115.42
|
| Rate for Payer: UMR Bronson Commercial |
$917.70
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$519.50 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.13
|
| Rate for Payer: BCBS Complete |
$891.20
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Commercial |
$727.30
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.88
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$980.32 |
| Max. Negotiated Rate |
$2,005.20 |
| Rate for Payer: Aetna American Axle |
$1,448.20
|
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.20
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,559.60
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,559.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,559.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health SBD |
$1,403.64
|
| Rate for Payer: UMR Bronson Commercial |
$980.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,228.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$824.36 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$1,448.20
|
| Rate for Payer: Aetna Commercial |
$1,893.80
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$1,916.08
|
| Rate for Payer: Cofinity Commercial |
$1,559.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,559.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,782.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,005.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,559.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.00
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,893.80
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,893.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,403.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$824.36
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.00
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,228.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$519.50 |
| Max. Negotiated Rate |
$1,448.20 |
| Rate for Payer: Aetna Commercial |
$696.13
|
| Rate for Payer: Aetna Medicare |
$540.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$748.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.13
|
| Rate for Payer: BCBS Complete |
$891.20
|
| Rate for Payer: BCBS MAPPO |
$519.50
|
| Rate for Payer: BCN Medicare Advantage |
$519.50
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cash Price |
$1,782.40
|
| Rate for Payer: Cofinity Commercial |
$748.08
|
| Rate for Payer: Cofinity Commercial |
$696.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.48
|
| Rate for Payer: Nomi Health Commercial |
$623.40
|
| Rate for Payer: PACE SWMI |
$519.50
|
| Rate for Payer: PHP Commercial |
$727.30
|
| Rate for Payer: PHP Medicare Advantage |
$519.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.20
|
| Rate for Payer: Priority Health Medicare |
$519.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.50
|
| Rate for Payer: UHC Medicare Advantage |
$519.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.88
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$456.21 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$801.45
|
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$863.10
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$863.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$863.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$776.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$456.21
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$433.92 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.45
|
| Rate for Payer: BCBS Complete |
$493.20
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Commercial |
$607.49
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UMR Bronson Commercial |
$567.18
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$542.52 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Aetna American Axle |
$801.45
|
| Rate for Payer: Aetna Commercial |
$1,048.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.45
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,060.38
|
| Rate for Payer: Cofinity Commercial |
$863.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$863.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Healthscope Commercial |
$1,109.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$863.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: PHP Commercial |
$1,048.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health SBD |
$776.79
|
| Rate for Payer: UMR Bronson Commercial |
$542.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.75
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$433.92 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$451.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.45
|
| Rate for Payer: BCBS Complete |
$493.20
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Commercial |
$607.49
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UMR Bronson Commercial |
$567.18
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$474.00 |
| Max. Negotiated Rate |
$1,029.96 |
| Rate for Payer: Aetna Commercial |
$958.43
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.96
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.43
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Commercial |
$1,001.35
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$438.45 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$770.25
|
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$829.50
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$829.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$829.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.75
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$438.45
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$521.40 |
| Max. Negotiated Rate |
$1,066.50 |
| Rate for Payer: Aetna American Axle |
$770.25
|
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,019.10
|
| Rate for Payer: Cofinity Commercial |
$829.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$829.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Healthscope Commercial |
$1,066.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$829.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: UMR Bronson Commercial |
$521.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.75
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$474.00 |
| Max. Negotiated Rate |
$1,029.96 |
| Rate for Payer: Aetna Commercial |
$958.43
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.96
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.43
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Commercial |
$1,001.35
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$644.56 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.71
|
| Rate for Payer: BCBS Complete |
$806.00
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Commercial |
$902.38
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UMR Bronson Commercial |
$926.90
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$644.56 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.71
|
| Rate for Payer: BCBS Complete |
$806.00
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Commercial |
$902.38
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UMR Bronson Commercial |
$926.90
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$886.60 |
| Max. Negotiated Rate |
$1,813.50 |
| Rate for Payer: Aetna American Axle |
$1,309.75
|
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,410.50
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health SBD |
$1,269.45
|
| Rate for Payer: UMR Bronson Commercial |
$886.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$745.55 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$1,309.75
|
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,732.90
|
| Rate for Payer: Cofinity Commercial |
$1,410.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,410.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,813.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.25
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,269.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$745.55
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$388.52 |
| Max. Negotiated Rate |
$794.70 |
| Rate for Payer: Aetna American Axle |
$573.95
|
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.95
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$618.10
|
| Rate for Payer: Cofinity Commercial |
$759.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$618.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Healthscope Commercial |
$794.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$618.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$662.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: PHP Commercial |
$750.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health SBD |
$556.29
|
| Rate for Payer: UMR Bronson Commercial |
$388.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$662.25
|
|
