|
EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 23075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$319.57 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.96
|
| Rate for Payer: BCN Commercial |
$1,107.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.53
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$319.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 23073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$678.41 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$2,950.42
|
| Rate for Payer: BCN Commercial |
$2,950.42
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.25
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$678.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 23076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$528.16 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: 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: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 27337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.10 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$2,440.51
|
| Rate for Payer: BCN Commercial |
$2,440.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.01
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$409.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 27327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$305.97 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.96
|
| Rate for Payer: BCN Commercial |
$1,384.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.57
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$305.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 27339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$736.18 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$1,874.25
|
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.80
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$736.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 27328
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$607.76 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$668.54
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$607.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 24071
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$395.18 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$2,388.54
|
| Rate for Payer: BCN Commercial |
$2,388.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.70
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$395.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 24073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$674.57 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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 |
$1,874.25
|
| Rate for Payer: BCN Commercial |
$1,874.25
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.03
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$674.57
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 24076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$531.26 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| 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: 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 Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$584.39
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$531.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); 1.5 CM OR GREATER
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 26113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$530.73 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,523.44
|
| Rate for Payer: BCN Commercial |
$1,523.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.80
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$530.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 26116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$509.22 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,292.63
|
| Rate for Payer: BCN Commercial |
$1,292.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.14
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$509.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$114.20
|
|
|
Service Code
|
NDC 68382038306
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.25 |
| Max. Negotiated Rate |
$102.78 |
| Rate for Payer: Aetna American Axle |
$74.23
|
| Rate for Payer: Aetna Commercial |
$97.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.23
|
| Rate for Payer: Cash Price |
$91.36
|
| Rate for Payer: Cofinity Commercial |
$79.94
|
| Rate for Payer: Cofinity Commercial |
$98.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.36
|
| Rate for Payer: Healthscope Commercial |
$102.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.07
|
| Rate for Payer: PHP Commercial |
$97.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.23
|
| Rate for Payer: Priority Health SBD |
$71.95
|
| Rate for Payer: UMR Bronson Commercial |
$50.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.65
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
OP
|
$4,152.85
|
|
|
Service Code
|
NDC 00009766304
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,536.55 |
| Max. Negotiated Rate |
$3,737.56 |
| Rate for Payer: Aetna American Axle |
$2,699.35
|
| Rate for Payer: Aetna Commercial |
$3,529.92
|
| Rate for Payer: Aetna Medicare |
$2,076.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,699.35
|
| Rate for Payer: BCBS Complete |
$1,661.14
|
| Rate for Payer: Cash Price |
$3,322.28
|
| Rate for Payer: Cofinity Commercial |
$2,907.00
|
| Rate for Payer: Cofinity Commercial |
$3,571.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,907.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,322.28
|
| Rate for Payer: Healthscope Commercial |
$3,737.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,907.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,114.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,529.92
|
| Rate for Payer: PHP Commercial |
$3,529.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,699.35
|
| Rate for Payer: Priority Health SBD |
$2,616.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,536.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,114.64
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$4,152.85
|
|
|
Service Code
|
NDC 00009766304
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,827.25 |
| Max. Negotiated Rate |
$3,737.56 |
| Rate for Payer: PHP Commercial |
$3,529.92
|
| Rate for Payer: Aetna American Axle |
$2,699.35
|
| Rate for Payer: Aetna Commercial |
$3,529.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,699.35
|
| Rate for Payer: Cash Price |
$3,322.28
|
| Rate for Payer: Cofinity Commercial |
$2,907.00
|
| Rate for Payer: Cofinity Commercial |
$3,571.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,907.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,322.28
|
| Rate for Payer: Healthscope Commercial |
$3,737.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,907.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,114.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,529.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,699.35
|
| Rate for Payer: Priority Health SBD |
$2,616.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,827.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,114.64
|
|
|
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: Cofinity Commercial |
$297.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.27
|
| Rate for Payer: Aetna American Axle |
$224.96
|
| Rate for Payer: Aetna Commercial |
$294.18
|
| Rate for Payer: Aetna Medicare |
$173.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.96
|
| Rate for Payer: BCBS Complete |
$138.44
|
| Rate for Payer: Cash Price |
$276.88
|
| Rate for Payer: Cofinity Commercial |
$242.27
|
| 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 |
$259.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.18
|
| Rate for Payer: PHP Commercial |
$294.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.96
|
| Rate for Payer: Priority Health SBD |
$218.04
|
| Rate for Payer: UMR Bronson Commercial |
$128.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.58
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
OP
|
$114.20
|
|
|
Service Code
|
NDC 68382038306
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$42.25 |
| Max. Negotiated Rate |
$102.78 |
| Rate for Payer: Aetna American Axle |
$74.23
|
| Rate for Payer: Aetna Commercial |
$97.07
|
| Rate for Payer: Aetna Medicare |
$57.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.23
|
| Rate for Payer: BCBS Complete |
$45.68
|
| Rate for Payer: Cash Price |
$91.36
|
| Rate for Payer: Cofinity Commercial |
$79.94
|
| Rate for Payer: Cofinity Commercial |
$98.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.36
|
| Rate for Payer: Healthscope Commercial |
$102.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.07
|
| Rate for Payer: PHP Commercial |
$97.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.23
|
| Rate for Payer: Priority Health SBD |
$71.95
|
| Rate for Payer: UMR Bronson Commercial |
$42.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.65
|
|
|
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 Commercial |
$784.69
|
| Rate for Payer: Cofinity Commercial |
$964.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$784.69
|
| 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: PHP Commercial |
$952.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.64
|
| 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
|
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 |
$224.96
|
| Rate for Payer: Aetna Commercial |
$294.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.96
|
| Rate for Payer: Cash Price |
$276.88
|
| Rate for Payer: Cofinity Commercial |
$242.27
|
| Rate for Payer: Cofinity Commercial |
$297.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.27
|
| 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 |
$259.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.18
|
| Rate for Payer: PHP Commercial |
$294.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.96
|
| 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 |
$259.58
|
|
|
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 Commercial |
$784.69
|
| Rate for Payer: Cofinity Commercial |
$964.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$784.69
|
| 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: PHP Commercial |
$952.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$728.64
|
| Rate for Payer: Priority Health SBD |
$706.22
|
| Rate for Payer: UMR Bronson Commercial |
$414.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$840.74
|
|
|
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 Commercial |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,800.60
|
| 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: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.99
|
| 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 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 Commercial |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,800.60
|
| 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: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.99
|
| Rate for Payer: Priority Health SBD |
$1,620.54
|
| 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 Commercial |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,800.60
|
| 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: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.99
|
| 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 Commercial |
$1,800.60
|
| Rate for Payer: Cofinity Commercial |
$2,212.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,800.60
|
| 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: PHP Commercial |
$2,186.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.99
|
| Rate for Payer: Priority Health SBD |
$1,620.54
|
| Rate for Payer: UMR Bronson Commercial |
$951.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.22
|
|
|
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; EXTREMITY
|
Facility
|
OP
|
$9,692.51
|
|
|
Service Code
|
CPT 35860
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$816.14 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,204.75
|
| Rate for Payer: BCN Commercial |
$2,204.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.75
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$816.14
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: VA VA |
$3,083.86
|
|
