|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$353.20 |
| Max. Negotiated Rate |
$720.17 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.16
|
| Rate for Payer: BCBS Complete |
$353.20
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Commercial |
$700.17
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UMR Bronson Commercial |
$406.18
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$326.71 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$573.95
|
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.95
|
| 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 |
$706.40
|
| 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: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| 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: 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 |
$750.55
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$750.55
|
| 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 |
$573.95
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$556.29
|
| 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 |
$326.71
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$662.25
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$353.20 |
| Max. Negotiated Rate |
$720.17 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.16
|
| Rate for Payer: BCBS Complete |
$353.20
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Commercial |
$700.17
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UMR Bronson Commercial |
$406.18
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$373.60 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$514.61
|
| Rate for Payer: Aetna Medicare |
$399.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.61
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS MAPPO |
$384.04
|
| Rate for Payer: BCN Medicare Advantage |
$384.04
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$553.02
|
| Rate for Payer: Cofinity Commercial |
$514.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.24
|
| Rate for Payer: Nomi Health Commercial |
$460.85
|
| Rate for Payer: PACE SWMI |
$384.04
|
| Rate for Payer: PHP Commercial |
$537.66
|
| Rate for Payer: PHP Medicare Advantage |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$384.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.04
|
| Rate for Payer: UHC Medicare Advantage |
$384.04
|
| Rate for Payer: UMR Bronson Commercial |
$429.64
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$411.45 |
| Max. Negotiated Rate |
$1,047.15 |
| Rate for Payer: Aetna Commercial |
$551.34
|
| Rate for Payer: Aetna Medicare |
$427.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.34
|
| Rate for Payer: BCBS Complete |
$644.40
|
| Rate for Payer: BCBS MAPPO |
$411.45
|
| Rate for Payer: BCN Medicare Advantage |
$411.45
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cofinity Commercial |
$592.49
|
| Rate for Payer: Cofinity Commercial |
$551.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.02
|
| Rate for Payer: Nomi Health Commercial |
$493.74
|
| Rate for Payer: PACE SWMI |
$411.45
|
| Rate for Payer: PHP Commercial |
$576.03
|
| Rate for Payer: PHP Medicare Advantage |
$411.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health Medicare |
$411.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.45
|
| Rate for Payer: UHC Medicare Advantage |
$411.45
|
| Rate for Payer: UMR Bronson Commercial |
$741.06
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$502.20 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$672.95
|
| Rate for Payer: Aetna Medicare |
$522.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.95
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$502.20
|
| Rate for Payer: BCN Medicare Advantage |
$502.20
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$723.17
|
| Rate for Payer: Cofinity Commercial |
$672.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.31
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PACE SWMI |
$502.20
|
| Rate for Payer: PHP Commercial |
$703.08
|
| Rate for Payer: PHP Medicare Advantage |
$502.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$502.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.20
|
| Rate for Payer: UHC Medicare Advantage |
$502.20
|
| Rate for Payer: UMR Bronson Commercial |
$828.92
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.16
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Commercial |
$713.75
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.16
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Commercial |
$713.75
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$762.96 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna American Axle |
$1,127.10
|
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,213.80
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,213.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,300.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health SBD |
$1,092.42
|
| Rate for Payer: UMR Bronson Commercial |
$762.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$641.58 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$1,127.10
|
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| 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 |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,213.80
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,213.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,213.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,300.50
|
| 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 |
$1,473.90
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| 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 |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,092.42
|
| 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 |
$641.58
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$408.80 |
| Max. Negotiated Rate |
$759.86 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.09
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Commercial |
$738.75
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UMR Bronson Commercial |
$470.12
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$378.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$664.30
|
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| 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 |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$715.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$766.50
|
| 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 |
$868.70
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$868.70
|
| 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 |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$643.86
|
| 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 |
$378.14
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$766.50
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$408.80 |
| Max. Negotiated Rate |
$759.86 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.09
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Commercial |
$738.75
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UMR Bronson Commercial |
$470.12
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$449.68 |
| Max. Negotiated Rate |
$919.80 |
| Rate for Payer: Aetna American Axle |
$664.30
|
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$715.40
|
| Rate for Payer: Cofinity Commercial |
$878.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$715.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$919.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$715.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$766.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health SBD |
$643.86
|
| Rate for Payer: UMR Bronson Commercial |
$449.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$766.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$464.40 |
| Max. Negotiated Rate |
$791.90 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.91
|
| Rate for Payer: BCBS Complete |
$464.40
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Commercial |
$769.90
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health Medicare |
$549.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UMR Bronson Commercial |
$534.06
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$429.57 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$754.65
|
| Rate for Payer: Aetna Commercial |
$986.85
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.65
|
| 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 |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$812.70
|
| Rate for Payer: Cofinity Commercial |
$998.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$812.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,044.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.75
|
| 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 |
$986.85
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$986.85
|
| 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 |
$754.65
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$731.43
|
| 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 |
$429.57
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.75
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$510.84 |
| Max. Negotiated Rate |
$1,044.90 |
| Rate for Payer: Aetna American Axle |
$754.65
|
| Rate for Payer: Aetna Commercial |
$986.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.65
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$812.70
|
| Rate for Payer: Cofinity Commercial |
$998.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$812.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Healthscope Commercial |
$1,044.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.85
|
| Rate for Payer: PHP Commercial |
$986.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health SBD |
$731.43
|
| Rate for Payer: UMR Bronson Commercial |
$510.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.75
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$464.40 |
| Max. Negotiated Rate |
$791.90 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.91
|
| Rate for Payer: BCBS Complete |
$464.40
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCN Medicare Advantage |
$549.93
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$736.91
|
| Rate for Payer: Cofinity Commercial |
$791.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$549.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$577.43
|
| Rate for Payer: Nomi Health Commercial |
$659.92
|
| Rate for Payer: PACE SWMI |
$549.93
|
| Rate for Payer: PHP Commercial |
$769.90
|
| Rate for Payer: PHP Medicare Advantage |
$549.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health Medicare |
$549.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UMR Bronson Commercial |
$534.06
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,203.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$481.20 |
| Max. Negotiated Rate |
$933.02 |
| Rate for Payer: Aetna Commercial |
$868.23
|
| Rate for Payer: Aetna Medicare |
$673.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$933.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$868.23
|
| Rate for Payer: BCBS Complete |
$481.20
|
| Rate for Payer: BCBS MAPPO |
$647.93
|
| Rate for Payer: BCN Medicare Advantage |
$647.93
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cofinity Commercial |
$933.02
|
| Rate for Payer: Cofinity Commercial |
$868.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.33
|
| Rate for Payer: Nomi Health Commercial |
$777.52
|
| Rate for Payer: PACE SWMI |
$647.93
|
| Rate for Payer: PHP Commercial |
$907.10
|
| Rate for Payer: PHP Medicare Advantage |
$647.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.95
|
| Rate for Payer: Priority Health Medicare |
$647.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.93
|
| Rate for Payer: UHC Medicare Advantage |
$647.93
|
| Rate for Payer: UMR Bronson Commercial |
$553.38
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$616.56 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$445.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.75
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCBS MAPPO |
$428.17
|
| Rate for Payer: BCN Medicare Advantage |
$428.17
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$616.56
|
| Rate for Payer: Cofinity Commercial |
$573.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.58
|
| Rate for Payer: Nomi Health Commercial |
$513.80
|
| Rate for Payer: PACE SWMI |
$428.17
|
| Rate for Payer: PHP Commercial |
$599.44
|
| Rate for Payer: PHP Medicare Advantage |
$428.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$428.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.17
|
| Rate for Payer: UHC Medicare Advantage |
$428.17
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$264.18 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| 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 |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| 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 |
$606.90
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$606.90
|
| 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 |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| 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 |
$264.18
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: UMR Bronson Commercial |
$314.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$616.56 |
| Rate for Payer: Aetna Commercial |
$573.75
|
| Rate for Payer: Aetna Medicare |
$445.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.75
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCBS MAPPO |
$428.17
|
| Rate for Payer: BCN Medicare Advantage |
$428.17
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$573.75
|
| Rate for Payer: Cofinity Commercial |
$616.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.58
|
| Rate for Payer: Nomi Health Commercial |
$513.80
|
| Rate for Payer: PACE SWMI |
$428.17
|
| Rate for Payer: PHP Commercial |
$599.44
|
| Rate for Payer: PHP Medicare Advantage |
$428.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health Medicare |
$428.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.17
|
| Rate for Payer: UHC Medicare Advantage |
$428.17
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$316.40 |
| Max. Negotiated Rate |
$514.15 |
| Rate for Payer: Aetna Commercial |
$433.09
|
| Rate for Payer: Aetna Medicare |
$336.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.09
|
| Rate for Payer: BCBS Complete |
$316.40
|
| Rate for Payer: BCBS MAPPO |
$323.20
|
| Rate for Payer: BCN Medicare Advantage |
$323.20
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cofinity Commercial |
$465.41
|
| Rate for Payer: Cofinity Commercial |
$433.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.36
|
| Rate for Payer: Nomi Health Commercial |
$387.84
|
| Rate for Payer: PACE SWMI |
$323.20
|
| Rate for Payer: PHP Commercial |
$452.48
|
| Rate for Payer: PHP Medicare Advantage |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.15
|
| Rate for Payer: Priority Health Medicare |
$323.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.20
|
| Rate for Payer: UHC Medicare Advantage |
$323.20
|
| Rate for Payer: UMR Bronson Commercial |
$363.86
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
OP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$446.22 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$783.90
|
| Rate for Payer: Aetna Commercial |
$1,025.10
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.90
|
| 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 |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$1,037.16
|
| Rate for Payer: Cofinity Commercial |
$844.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$844.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,085.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$844.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$904.50
|
| 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 |
$1,025.10
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$1,025.10
|
| 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 |
$783.90
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$759.78
|
| 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 |
$446.22
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$904.50
|
|
