|
EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 27043
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,133.15
|
| Rate for Payer: BCN Commercial |
$3,133.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 27047
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.82
|
| Rate for Payer: BCN Commercial |
$1,940.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 27045
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.27
|
| Rate for Payer: BCN Commercial |
$2,264.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 23071
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,169.44
|
| Rate for Payer: BCN Commercial |
$3,169.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 23076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.82
|
| Rate for Payer: BCN Commercial |
$1,940.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 27337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,948.37
|
| Rate for Payer: BCN Commercial |
$2,948.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 27327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.17
|
| Rate for Payer: BCN Commercial |
$1,673.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 27339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.27
|
| Rate for Payer: BCN Commercial |
$2,264.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 24071
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,885.58
|
| Rate for Payer: BCN Commercial |
$2,885.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 24073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,264.27
|
| Rate for Payer: BCN Commercial |
$2,264.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); 1.5 CM OR GREATER
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 26113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.46
|
| Rate for Payer: BCN Commercial |
$1,840.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 26116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.62
|
| Rate for Payer: BCN Commercial |
$1,561.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$346.10
|
|
|
Service Code
|
NDC 47781010830
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.28 |
| Max. Negotiated Rate |
$311.49 |
| Rate for Payer: Aetna American Axle |
$224.97
|
| Rate for Payer: Aetna Commercial |
$294.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.97
|
| Rate for Payer: Cash Price |
$276.88
|
| Rate for Payer: Cofinity Advantage |
$242.27
|
| Rate for Payer: Cofinity Commercial |
$297.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.88
|
| Rate for Payer: Healthscope Commercial |
$311.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.57
|
| Rate for Payer: PHP Commercial |
$294.19
|
| Rate for Payer: Priority Health SBD |
$218.04
|
| Rate for Payer: UMR Bronson Commercial |
$152.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.57
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
OP
|
$136.95
|
|
|
Service Code
|
NDC 68382038306
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.67 |
| Max. Negotiated Rate |
$123.25 |
| Rate for Payer: Aetna American Axle |
$89.02
|
| Rate for Payer: Aetna Commercial |
$116.41
|
| Rate for Payer: Aetna Medicare |
$68.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.02
|
| Rate for Payer: BCBS Complete |
$54.78
|
| Rate for Payer: Cash Price |
$109.56
|
| Rate for Payer: Cofinity Advantage |
$95.86
|
| Rate for Payer: Cofinity Commercial |
$117.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.56
|
| Rate for Payer: Healthscope Commercial |
$123.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.71
|
| Rate for Payer: PHP Commercial |
$116.41
|
| Rate for Payer: Priority Health SBD |
$86.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.02
|
| Rate for Payer: UHC Core |
$71.35
|
| Rate for Payer: UHC Exchange |
$53.82
|
| Rate for Payer: UMR Bronson Commercial |
$50.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.71
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$136.95
|
|
|
Service Code
|
NDC 68382038306
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.26 |
| Max. Negotiated Rate |
$123.25 |
| Rate for Payer: Aetna American Axle |
$89.02
|
| Rate for Payer: Aetna Commercial |
$116.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.02
|
| Rate for Payer: Cash Price |
$109.56
|
| Rate for Payer: Cofinity Advantage |
$95.86
|
| Rate for Payer: Cofinity Commercial |
$117.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.56
|
| Rate for Payer: Healthscope Commercial |
$123.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.71
|
| Rate for Payer: PHP Commercial |
$116.41
|
| Rate for Payer: Priority Health SBD |
$86.28
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.71
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
OP
|
$1,120.99
|
|
|
Service Code
|
NDC 00054008013
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$414.77 |
| Max. Negotiated Rate |
$1,008.89 |
| Rate for Payer: Aetna American Axle |
$728.64
|
| Rate for Payer: Aetna Commercial |
$952.84
|
| Rate for Payer: Aetna Medicare |
$560.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.64
|
| Rate for Payer: BCBS Complete |
$448.40
|
| Rate for Payer: Cash Price |
$896.79
|
| Rate for Payer: Cofinity Advantage |
$784.69
|
| Rate for Payer: Cofinity Commercial |
$964.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$896.79
|
| Rate for Payer: Healthscope Commercial |
$1,008.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$784.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$840.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$896.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$952.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$840.74
|
| Rate for Payer: PHP Commercial |
$952.84
|
| Rate for Payer: Priority Health SBD |
$706.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.64
|
| Rate for Payer: UHC Core |
$584.04
|
| Rate for Payer: UHC Exchange |
$440.55
|
| Rate for Payer: UMR Bronson Commercial |
$414.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$840.74
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$1,120.99
|
|
|
Service Code
|
NDC 00054008013
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$493.24 |
| Max. Negotiated Rate |
$1,008.89 |
| Rate for Payer: Aetna American Axle |
$728.64
|
| Rate for Payer: Aetna Commercial |
$952.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.64
|
| Rate for Payer: Cash Price |
$896.79
|
| Rate for Payer: Cofinity Advantage |
$784.69
|
| Rate for Payer: Cofinity Commercial |
$964.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$896.79
|
| Rate for Payer: Healthscope Commercial |
$1,008.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$784.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$840.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$952.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$840.74
|
| Rate for Payer: PHP Commercial |
$952.84
|
| Rate for Payer: Priority Health SBD |
$706.22
|
| Rate for Payer: UMR Bronson Commercial |
$493.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$840.74
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
OP
|
$346.10
|
|
|
Service Code
|
NDC 47781010830
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$128.06 |
| Max. Negotiated Rate |
$311.49 |
| Rate for Payer: Aetna American Axle |
$224.97
|
| Rate for Payer: Aetna Commercial |
$294.19
|
| Rate for Payer: Aetna Medicare |
$173.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.97
|
| Rate for Payer: BCBS Complete |
$138.44
|
| Rate for Payer: Cash Price |
$276.88
|
| Rate for Payer: Cofinity Advantage |
$242.27
|
| Rate for Payer: Cofinity Commercial |
$297.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.88
|
| Rate for Payer: Healthscope Commercial |
$311.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.57
|
| Rate for Payer: PHP Commercial |
$294.19
|
| Rate for Payer: Priority Health SBD |
$218.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.97
|
| Rate for Payer: UHC Core |
$180.32
|
| Rate for Payer: UHC Exchange |
$136.02
|
| Rate for Payer: UMR Bronson Commercial |
$128.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.57
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$4,360.53
|
|
|
Service Code
|
NDC 00009766304
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,918.63 |
| Max. Negotiated Rate |
$3,924.48 |
| Rate for Payer: Aetna American Axle |
$2,834.34
|
| Rate for Payer: Aetna Commercial |
$3,706.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,834.34
|
| Rate for Payer: Cash Price |
$3,488.42
|
| Rate for Payer: Cofinity Advantage |
$3,052.37
|
| Rate for Payer: Cofinity Commercial |
$3,750.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,488.42
|
| Rate for Payer: Healthscope Commercial |
$3,924.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,052.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,270.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,706.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,270.40
|
| Rate for Payer: PHP Commercial |
$3,706.45
|
| Rate for Payer: Priority Health SBD |
$2,747.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,918.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,270.40
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
OP
|
$4,360.53
|
|
|
Service Code
|
NDC 00009766304
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,613.40 |
| Max. Negotiated Rate |
$3,924.48 |
| Rate for Payer: Aetna American Axle |
$2,834.34
|
| Rate for Payer: Aetna Commercial |
$3,706.45
|
| Rate for Payer: Aetna Medicare |
$2,180.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,834.34
|
| Rate for Payer: BCBS Complete |
$1,744.21
|
| Rate for Payer: Cash Price |
$3,488.42
|
| Rate for Payer: Cofinity Advantage |
$3,052.37
|
| Rate for Payer: Cofinity Commercial |
$3,750.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,488.42
|
| Rate for Payer: Healthscope Commercial |
$3,924.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,052.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,270.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,488.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,706.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,270.40
|
| Rate for Payer: PHP Commercial |
$3,706.45
|
| Rate for Payer: Priority Health SBD |
$2,747.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,834.34
|
| Rate for Payer: UHC Core |
$2,271.84
|
| Rate for Payer: UHC Exchange |
$1,713.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,613.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,270.40
|
|
|
EXENATIDE 10 MCG/DOSE(250 MCG/ML)2.4 ML SUBCUTANEOUS PEN INJECTOR
|
Facility
|
OP
|
$2,572.29
|
|
|
Service Code
|
NDC 00310652401
|
| Hospital Charge Code |
105629
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$951.75 |
| Max. Negotiated Rate |
$2,315.06 |
| Rate for Payer: Aetna American Axle |
$1,671.99
|
| Rate for Payer: Aetna Commercial |
$2,186.45
|
| Rate for Payer: Aetna Medicare |
$1,286.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.99
|
| Rate for Payer: BCBS Complete |
$1,028.92
|
| Rate for Payer: Cash Price |
$2,057.83
|
| Rate for Payer: Cofinity Advantage |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.83
|
| Rate for Payer: Healthscope Commercial |
$2,315.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,800.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,057.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,929.22
|
| Rate for Payer: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health SBD |
$1,620.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,671.99
|
| Rate for Payer: UHC Core |
$1,340.16
|
| Rate for Payer: UHC Exchange |
$1,010.91
|
| Rate for Payer: UMR Bronson Commercial |
$951.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.22
|
|
|
EXENATIDE 10 MCG/DOSE(250 MCG/ML)2.4 ML SUBCUTANEOUS PEN INJECTOR
|
Facility
|
IP
|
$2,572.29
|
|
|
Service Code
|
NDC 00310652401
|
| Hospital Charge Code |
105629
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1,131.81 |
| Max. Negotiated Rate |
$2,315.06 |
| Rate for Payer: Aetna American Axle |
$1,671.99
|
| Rate for Payer: Aetna Commercial |
$2,186.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.99
|
| Rate for Payer: Cash Price |
$2,057.83
|
| Rate for Payer: Cofinity Advantage |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.83
|
| Rate for Payer: Healthscope Commercial |
$2,315.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,800.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,929.22
|
| Rate for Payer: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health SBD |
$1,620.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,131.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.22
|
|
|
EXENATIDE 5 MCG/DOSE (250 MCG/ML)1.2 ML SUBCUTANEOUS PEN INJECTOR
|
Facility
|
OP
|
$2,572.29
|
|
|
Service Code
|
NDC 00310651201
|
| Hospital Charge Code |
41283
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$951.75 |
| Max. Negotiated Rate |
$2,315.06 |
| Rate for Payer: Aetna American Axle |
$1,671.99
|
| Rate for Payer: Aetna Commercial |
$2,186.45
|
| Rate for Payer: Aetna Medicare |
$1,286.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.99
|
| Rate for Payer: BCBS Complete |
$1,028.92
|
| Rate for Payer: Cash Price |
$2,057.83
|
| Rate for Payer: Cofinity Advantage |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.83
|
| Rate for Payer: Healthscope Commercial |
$2,315.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,800.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,057.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,929.22
|
| Rate for Payer: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health SBD |
$1,620.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,671.99
|
| Rate for Payer: UHC Core |
$1,340.16
|
| Rate for Payer: UHC Exchange |
$1,010.91
|
| Rate for Payer: UMR Bronson Commercial |
$951.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.22
|
|
|
EXENATIDE 5 MCG/DOSE (250 MCG/ML)1.2 ML SUBCUTANEOUS PEN INJECTOR
|
Facility
|
IP
|
$2,572.29
|
|
|
Service Code
|
NDC 00310651201
|
| Hospital Charge Code |
41283
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1,131.81 |
| Max. Negotiated Rate |
$2,315.06 |
| Rate for Payer: Aetna American Axle |
$1,671.99
|
| Rate for Payer: Aetna Commercial |
$2,186.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.99
|
| Rate for Payer: Cash Price |
$2,057.83
|
| Rate for Payer: Cofinity Advantage |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.83
|
| Rate for Payer: Healthscope Commercial |
$2,315.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,800.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,929.22
|
| Rate for Payer: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health SBD |
$1,620.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,131.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.22
|
|
|
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; EXTREMITY
|
Facility
|
OP
|
$10,174.29
|
|
|
Service Code
|
CPT 35860
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,663.55
|
| Rate for Payer: BCN Commercial |
$2,663.55
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: VA VA |
$3,146.13
|
|
