|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,125.81 |
| Rate for Payer: Aetna Commercial |
$403.90
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.31
|
| Rate for Payer: Priority Health Narrow Network |
$470.31
|
| Rate for Payer: Priority Health SBD |
$470.31
|
| Rate for Payer: UMR Bronson Commercial |
$488.98
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,063.00
|
|
|
Service Code
|
HCPCS 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$198.52 |
| Max. Negotiated Rate |
$1,125.81 |
| Rate for Payer: Aetna Commercial |
$403.90
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Meridian Medicaid |
$208.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$470.31
|
| Rate for Payer: Priority Health Narrow Network |
$470.31
|
| Rate for Payer: Priority Health SBD |
$470.31
|
| Rate for Payer: UMR Bronson Commercial |
$488.98
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
OP
|
$1,063.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$305.18 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$690.95
|
| Rate for Payer: Aetna Commercial |
$903.55
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$690.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,276.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cash Price |
$850.40
|
| Rate for Payer: Cofinity Commercial |
$914.18
|
| Rate for Payer: Cofinity Commercial |
$744.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$850.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$956.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$744.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$797.25
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$903.55
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$903.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$669.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$305.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$393.31
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$797.25
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna American Axle |
$513.50
|
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.50
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$553.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health SBD |
$497.70
|
| Rate for Payer: UMR Bronson Commercial |
$347.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna Commercial |
$404.86
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.84
|
| Rate for Payer: Priority Health Narrow Network |
$471.84
|
| Rate for Payer: Priority Health SBD |
$471.84
|
| Rate for Payer: UMR Bronson Commercial |
$363.40
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$292.30 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$513.50
|
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,412.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$553.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$497.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$305.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$292.30
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$790.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna Commercial |
$404.86
|
| Rate for Payer: BCBS Complete |
$208.89
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Meridian Medicaid |
$208.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.84
|
| Rate for Payer: Priority Health Narrow Network |
$471.84
|
| Rate for Payer: Priority Health SBD |
$471.84
|
| Rate for Payer: UMR Bronson Commercial |
$363.40
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
IP
|
$2,102.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$924.88 |
| Max. Negotiated Rate |
$1,891.80 |
| Rate for Payer: Aetna American Axle |
$1,366.30
|
| Rate for Payer: Aetna Commercial |
$1,786.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.30
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cofinity Commercial |
$1,471.40
|
| Rate for Payer: Cofinity Commercial |
$1,807.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.60
|
| Rate for Payer: Healthscope Commercial |
$1,891.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,471.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,786.70
|
| Rate for Payer: PHP Commercial |
$1,786.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health SBD |
$1,324.26
|
| Rate for Payer: UMR Bronson Commercial |
$924.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
OP
|
$2,102.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$723.65 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$1,366.30
|
| Rate for Payer: Aetna Commercial |
$1,786.70
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,182.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cofinity Commercial |
$1,471.40
|
| Rate for Payer: Cofinity Commercial |
$1,807.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,891.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,471.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.50
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,786.70
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,786.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$1,324.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$796.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$723.65
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$777.74
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,102.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$240.88 |
| Max. Negotiated Rate |
$1,471.40 |
| Rate for Payer: Aetna Commercial |
$976.70
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS Trust/PPO |
$240.88
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,120.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.37
|
| Rate for Payer: Priority Health SBD |
$1,120.37
|
| Rate for Payer: UMR Bronson Commercial |
$966.92
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,102.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$240.88 |
| Max. Negotiated Rate |
$1,471.40 |
| Rate for Payer: Aetna Commercial |
$976.70
|
| Rate for Payer: BCBS Complete |
$494.27
|
| Rate for Payer: BCBS Trust/PPO |
$240.88
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Cash Price |
$1,681.60
|
| Rate for Payer: Meridian Medicaid |
$494.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,471.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,120.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,120.37
|
| Rate for Payer: Priority Health SBD |
$1,120.37
|
| Rate for Payer: UMR Bronson Commercial |
$966.92
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$395.54 |
| Max. Negotiated Rate |
$4,154.02 |
| Rate for Payer: Aetna Commercial |
$818.66
|
| Rate for Payer: BCBS Complete |
$415.32
|
| Rate for Payer: BCBS Trust/PPO |
$4,154.02
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Meridian Medicaid |
$415.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.59
|
| Rate for Payer: Priority Health Narrow Network |
$939.59
|
| Rate for Payer: Priority Health SBD |
$939.59
|
| Rate for Payer: UMR Bronson Commercial |
$572.24
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
IP
|
$1,244.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$547.36 |
| Max. Negotiated Rate |
$1,119.60 |
| Rate for Payer: Aetna American Axle |
$808.60
|
| Rate for Payer: Aetna Commercial |
$1,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.60
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$1,069.84
|
| Rate for Payer: Cofinity Commercial |
$870.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$995.20
|
| Rate for Payer: Healthscope Commercial |
$1,119.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$870.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$933.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,057.40
|
| Rate for Payer: PHP Commercial |
$1,057.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.80
|
| Rate for Payer: Priority Health SBD |
$783.72
|
| Rate for Payer: UMR Bronson Commercial |
$547.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$933.00
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
OP
|
$1,244.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$460.28 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$808.60
|
| Rate for Payer: Aetna Commercial |
$1,057.40
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cofinity Commercial |
$870.80
|
| Rate for Payer: Cofinity Commercial |
$1,069.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$995.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,119.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$870.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$933.00
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,057.40
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,057.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$783.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$668.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$608.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$460.28
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$933.00
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,244.00
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$395.54 |
| Max. Negotiated Rate |
$4,154.02 |
| Rate for Payer: Aetna Commercial |
$818.66
|
| Rate for Payer: BCBS Complete |
$415.32
|
| Rate for Payer: BCBS Trust/PPO |
$4,154.02
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Cash Price |
$995.20
|
| Rate for Payer: Meridian Medicaid |
$415.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$939.59
|
| Rate for Payer: Priority Health Narrow Network |
$939.59
|
| Rate for Payer: Priority Health SBD |
$939.59
|
| Rate for Payer: UMR Bronson Commercial |
$572.24
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$1,372.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$137.89 |
| Max. Negotiated Rate |
$1,127.52 |
| Rate for Payer: Aetna Commercial |
$985.74
|
| Rate for Payer: BCBS Complete |
$495.61
|
| Rate for Payer: BCBS Trust/PPO |
$137.89
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Cash Price |
$1,097.60
|
| Rate for Payer: Meridian Medicaid |
$495.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$960.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.52
|
| Rate for Payer: Priority Health SBD |
$1,127.52
|
| Rate for Payer: UMR Bronson Commercial |
$631.12
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$234.51 |
| Max. Negotiated Rate |
$3,876.14 |
| Rate for Payer: Aetna Commercial |
$478.89
|
| Rate for Payer: BCBS Complete |
$246.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.14
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Meridian Medicaid |
$246.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.06
|
| Rate for Payer: Priority Health Narrow Network |
$554.06
|
| Rate for Payer: Priority Health SBD |
$554.06
|
| Rate for Payer: UMR Bronson Commercial |
$362.48
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$1,089.20 |
| Rate for Payer: Aetna Commercial |
$933.13
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,069.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.30
|
| Rate for Payer: Priority Health SBD |
$1,069.30
|
| Rate for Payer: UMR Bronson Commercial |
$715.76
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$1,089.20 |
| Rate for Payer: Aetna Commercial |
$933.13
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,069.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.30
|
| Rate for Payer: Priority Health SBD |
$1,069.30
|
| Rate for Payer: UMR Bronson Commercial |
$715.76
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,556.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$575.72 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$1,011.40
|
| Rate for Payer: Aetna Commercial |
$1,322.60
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,813.11
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$1,338.16
|
| Rate for Payer: Cofinity Commercial |
$1,089.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,400.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,089.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.00
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,322.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,322.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$980.28
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$690.90
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$575.72
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.00
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,556.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$684.64 |
| Max. Negotiated Rate |
$1,400.40 |
| Rate for Payer: Aetna American Axle |
$1,011.40
|
| Rate for Payer: Aetna Commercial |
$1,322.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.40
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$1,089.20
|
| Rate for Payer: Cofinity Commercial |
$1,338.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.80
|
| Rate for Payer: Healthscope Commercial |
$1,400.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,089.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,322.60
|
| Rate for Payer: PHP Commercial |
$1,322.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: Priority Health SBD |
$980.28
|
| Rate for Payer: UMR Bronson Commercial |
$684.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.00
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,212.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$2,248.40 |
| Rate for Payer: Aetna Commercial |
$1,008.38
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.52
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,248.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.58
|
| Rate for Payer: Priority Health SBD |
$1,154.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,477.52
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$403.42 |
| Max. Negotiated Rate |
$1,529.96 |
| Rate for Payer: Aetna Commercial |
$832.30
|
| Rate for Payer: BCBS Complete |
$423.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.96
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Meridian Medicaid |
$423.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.49
|
| Rate for Payer: Priority Health Narrow Network |
$958.49
|
| Rate for Payer: Priority Health SBD |
$958.49
|
| Rate for Payer: UMR Bronson Commercial |
$788.44
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,526.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$671.44 |
| Max. Negotiated Rate |
$1,373.40 |
| Rate for Payer: Aetna American Axle |
$991.90
|
| Rate for Payer: Aetna Commercial |
$1,297.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.90
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,068.20
|
| Rate for Payer: Cofinity Commercial |
$1,312.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,220.80
|
| Rate for Payer: Healthscope Commercial |
$1,373.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,068.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,144.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,297.10
|
| Rate for Payer: PHP Commercial |
$1,297.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,068.20
|
| Rate for Payer: Priority Health SBD |
$961.38
|
| Rate for Payer: UMR Bronson Commercial |
$671.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,144.50
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$1,068.20 |
| Rate for Payer: Aetna Commercial |
$542.43
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,068.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.99
|
| Rate for Payer: Priority Health Narrow Network |
$622.99
|
| Rate for Payer: Priority Health SBD |
$622.99
|
| Rate for Payer: UMR Bronson Commercial |
$701.96
|
|
