|
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 |
$25.86 |
| 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) |
$581.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.84
|
| Rate for Payer: BCBS Complete |
$305.51
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| 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 |
$581.45
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| 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: Meridian Medicaid |
$305.51
|
| 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 Choice Medicaid |
$290.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$690.02
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: Priority Health Narrow Network |
$690.02
|
| Rate for Payer: Priority Health SBD |
$690.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP Medicaid |
$290.96
|
| 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 |
$35.00 |
| Max. Negotiated Rate |
$1,134.25 |
| Rate for Payer: Aetna Commercial |
$958.44
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| 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 |
$1,029.96
|
| Rate for Payer: Cofinity Commercial |
$958.44
|
| 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: Meridian Medicaid |
$501.87
|
| 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 Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: Priority Health SBD |
$1,134.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
| Rate for Payer: UMR Bronson Commercial |
$545.10
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,134.25 |
| Rate for Payer: Aetna Commercial |
$958.44
|
| Rate for Payer: Aetna Medicare |
$743.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,029.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: BCBS Complete |
$501.87
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| 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 |
$1,029.96
|
| Rate for Payer: Cofinity Commercial |
$958.44
|
| 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: Meridian Medicaid |
$501.87
|
| 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 Choice Medicaid |
$477.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,134.25
|
| Rate for Payer: Priority Health SBD |
$1,134.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP Medicaid |
$477.97
|
| 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 |
$8,813.49 |
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,689.54
|
| Rate for Payer: BCN Commercial |
$2,689.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$948.00
|
| 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: Aetna American Axle |
$770.25
|
| Rate for Payer: Aetna Commercial |
$1,007.25
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,007.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$746.55
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.80
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$719.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$438.45
|
| Rate for Payer: VA VA |
$2,804.18
|
| 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 <5CM
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$645.46 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Priority Health SBD |
$1,269.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$710.01
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$645.46
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$745.55
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Aetna American Axle |
$1,309.75
|
| Rate for Payer: Aetna Commercial |
$1,712.75
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,612.00
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,712.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$670.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$863.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.17
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| 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: Meridian Medicaid |
$453.34
|
| 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 Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.75
|
| Rate for Payer: Priority Health SBD |
$1,019.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
| 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 |
$120.86 |
| 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) |
$863.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.17
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| 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 |
$863.71
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| 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: Meridian Medicaid |
$453.34
|
| 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 Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.75
|
| Rate for Payer: Priority Health SBD |
$1,019.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
| 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 FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.17
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| 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 |
$670.16
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| 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: Meridian Medicaid |
$355.38
|
| 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 Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.99
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: Priority Health Narrow Network |
$802.99
|
| Rate for Payer: Priority Health SBD |
$802.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
| Rate for Payer: UMR Bronson Commercial |
$406.18
|
|
|
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
|
|
|
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 |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$573.95
|
| Rate for Payer: Aetna Commercial |
$750.55
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,507.26
|
| Rate for Payer: BCN Commercial |
$2,507.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$706.40
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$750.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$556.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$553.39
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$503.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$326.71
|
| Rate for Payer: VA VA |
$2,804.18
|
| 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
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$520.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.17
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| 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 |
$670.16
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| 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: Meridian Medicaid |
$355.38
|
| 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 Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.99
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: Priority Health Narrow Network |
$802.99
|
| Rate for Payer: Priority Health SBD |
$802.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
| 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 |
$260.50 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$514.61
|
| Rate for Payer: Aetna Medicare |
$399.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$514.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.02
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS MAPPO |
$384.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$789.70
|
| 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 |
$514.61
|
| Rate for Payer: Cofinity Commercial |
$553.02
|
| 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: Meridian Medicaid |
$273.52
|
| 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 Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.29
|
| Rate for Payer: Priority Health Medicare |
$384.04
|
| Rate for Payer: Priority Health Narrow Network |
$619.29
|
| Rate for Payer: Priority Health SBD |
$619.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.04
|
| Rate for Payer: UHC Medicare Advantage |
$384.04
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
| 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 |
$171.70 |
| 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) |
$551.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.49
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$411.45
|
| Rate for Payer: BCBS Trust/PPO |
$171.70
|
| Rate for Payer: BCN Commercial |
$624.04
|
| 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 |
$551.34
|
| Rate for Payer: Cofinity Commercial |
$592.49
|
| 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: Meridian Medicaid |
$291.20
|
| 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 Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$656.94
|
| Rate for Payer: Priority Health Medicare |
$411.45
|
| Rate for Payer: Priority Health Narrow Network |
$656.94
|
| Rate for Payer: Priority Health SBD |
$656.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.45
|
| Rate for Payer: UHC Medicare Advantage |
$411.45
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
| 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 |
$235.09 |
| 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) |
$672.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.17
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS MAPPO |
$502.20
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$767.22
|
| 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 |
$672.95
|
| Rate for Payer: Cofinity Commercial |
$723.17
|
| 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: Meridian Medicaid |
$358.06
|
| 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 Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$806.03
|
| Rate for Payer: Priority Health Medicare |
$502.20
|
| Rate for Payer: Priority Health Narrow Network |
$806.03
|
| Rate for Payer: Priority Health SBD |
$806.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.20
|
| Rate for Payer: UHC Medicare Advantage |
$502.20
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
| 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 |
$57.48 |
| Max. Negotiated Rate |
$1,127.10 |
| 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: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$530.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.14
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| 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: Meridian Medicaid |
$360.75
|
| 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 Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.21
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: Priority Health Narrow Network |
$816.21
|
| Rate for Payer: Priority Health SBD |
$816.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
| 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 |
$513.66 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$1,127.10
|
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,652.99
|
| Rate for Payer: BCN Commercial |
$2,652.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,387.20
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$1,092.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.03
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$513.66
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$641.58
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$57.48 |
| 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) |
$683.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.14
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| 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: Meridian Medicaid |
$360.75
|
| 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 Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.21
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: Priority Health Narrow Network |
$816.21
|
| Rate for Payer: Priority Health SBD |
$816.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
| Rate for Payer: UMR Bronson Commercial |
$797.64
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$840.13 |
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.86
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| 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: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| 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 Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.13
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: Priority Health Narrow Network |
$840.13
|
| Rate for Payer: Priority Health SBD |
$840.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
| 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 |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$664.30
|
| Rate for Payer: Aetna Commercial |
$868.70
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$817.60
|
| 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 |
$2,804.18
|
| 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 |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$868.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$643.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.98
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$528.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$378.14
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$766.50
|
|
|
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 TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$840.13 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$548.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$759.86
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| 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: Meridian Medicaid |
$373.95
|
| 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 Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.13
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: Priority Health Narrow Network |
$840.13
|
| Rate for Payer: Priority Health SBD |
$840.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
| Rate for Payer: UMR Bronson Commercial |
$470.12
|
|
|
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 |
$232.20 |
| Max. Negotiated Rate |
$872.70 |
| Rate for Payer: Aetna Commercial |
$736.91
|
| Rate for Payer: Aetna Medicare |
$571.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$791.90
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$549.93
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| 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: Meridian Medicaid |
$386.91
|
| 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 Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Medicare |
$549.93
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: Priority Health SBD |
$872.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$549.93
|
| Rate for Payer: UHC Medicare Advantage |
$549.93
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
| Rate for Payer: UMR Bronson Commercial |
$534.06
|
|
