|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 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
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,526.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$403.41 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$991.90
|
| Rate for Payer: Aetna Commercial |
$1,297.10
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$991.90
|
| 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 |
$2,277.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,312.36
|
| Rate for Payer: Cofinity Commercial |
$1,068.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,220.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| 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: 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 |
$1,297.10
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,297.10
|
| 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 |
$1,068.20
|
| 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 |
$961.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$403.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$564.62
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,144.50
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$890.40 |
| Rate for Payer: Aetna Commercial |
$437.22
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.61
|
| Rate for Payer: Priority Health Narrow Network |
$508.61
|
| Rate for Payer: Priority Health SBD |
$508.61
|
| Rate for Payer: UMR Bronson Commercial |
$585.12
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$890.40 |
| Rate for Payer: Aetna Commercial |
$437.22
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.61
|
| Rate for Payer: Priority Health Narrow Network |
$508.61
|
| Rate for Payer: Priority Health SBD |
$508.61
|
| Rate for Payer: UMR Bronson Commercial |
$585.12
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,272.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$559.68 |
| Max. Negotiated Rate |
$1,144.80 |
| Rate for Payer: Aetna American Axle |
$826.80
|
| Rate for Payer: Aetna Commercial |
$1,081.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.80
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$1,093.92
|
| Rate for Payer: Cofinity Commercial |
$890.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,017.60
|
| Rate for Payer: Healthscope Commercial |
$1,144.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$890.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,081.20
|
| Rate for Payer: PHP Commercial |
$1,081.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
| Rate for Payer: Priority Health SBD |
$801.36
|
| Rate for Payer: UMR Bronson Commercial |
$559.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,272.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$329.08 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$826.80
|
| Rate for Payer: Aetna Commercial |
$1,081.20
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$826.80
|
| 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 |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$1,093.92
|
| Rate for Payer: Cofinity Commercial |
$890.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,017.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,144.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$890.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.00
|
| 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 |
$1,081.20
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,081.20
|
| 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 |
$890.40
|
| 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 |
$801.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.99
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$329.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$470.64
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,660.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$614.20 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$1,079.00
|
| Rate for Payer: Aetna Commercial |
$1,411.00
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.00
|
| 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 |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cofinity Commercial |
$1,427.60
|
| Rate for Payer: Cofinity Commercial |
$1,162.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,494.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,162.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,245.00
|
| 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 |
$1,411.00
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,411.00
|
| 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 |
$1,162.00
|
| 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 |
$1,045.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$686.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$614.20
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,245.00
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,660.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: Aetna Commercial |
$928.71
|
| Rate for Payer: BCBS Complete |
$469.21
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Meridian Medicaid |
$469.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.17
|
| Rate for Payer: Priority Health SBD |
$1,063.17
|
| Rate for Payer: UMR Bronson Commercial |
$763.60
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,660.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: Aetna Commercial |
$928.71
|
| Rate for Payer: BCBS Complete |
$469.21
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Meridian Medicaid |
$469.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,063.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.17
|
| Rate for Payer: Priority Health SBD |
$1,063.17
|
| Rate for Payer: UMR Bronson Commercial |
$763.60
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,660.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$730.40 |
| Max. Negotiated Rate |
$1,494.00 |
| Rate for Payer: Aetna American Axle |
$1,079.00
|
| Rate for Payer: Aetna Commercial |
$1,411.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cofinity Commercial |
$1,162.00
|
| Rate for Payer: Cofinity Commercial |
$1,427.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.00
|
| Rate for Payer: Healthscope Commercial |
$1,494.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,162.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,245.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.00
|
| Rate for Payer: PHP Commercial |
$1,411.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.00
|
| Rate for Payer: Priority Health SBD |
$1,045.80
|
| Rate for Payer: UMR Bronson Commercial |
$730.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,245.00
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
24076
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$843.09 |
| Rate for Payer: Aetna Commercial |
$725.09
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$843.09
|
| Rate for Payer: Priority Health Narrow Network |
$843.09
|
| Rate for Payer: Priority Health SBD |
$843.09
|
| Rate for Payer: UMR Bronson Commercial |
$520.72
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$1,132.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$418.84 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$735.80
|
| Rate for Payer: Aetna Commercial |
$962.20
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.80
|
| 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 |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$973.52
|
| Rate for Payer: Cofinity Commercial |
$792.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$905.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,018.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$792.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$849.00
|
| 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 |
$962.20
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$962.20
|
| 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 |
$792.40
|
| 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 |
$713.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$544.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$418.84
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$849.00
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,132.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$843.09 |
| Rate for Payer: Aetna Commercial |
$725.09
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$843.09
|
| Rate for Payer: Priority Health Narrow Network |
$843.09
|
| Rate for Payer: Priority Health SBD |
$843.09
|
| Rate for Payer: UMR Bronson Commercial |
$520.72
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$1,132.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$498.08 |
| Max. Negotiated Rate |
$1,018.80 |
| Rate for Payer: Aetna American Axle |
$735.80
|
| Rate for Payer: Aetna Commercial |
$962.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$735.80
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$792.40
|
| Rate for Payer: Cofinity Commercial |
$973.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$905.60
|
| Rate for Payer: Healthscope Commercial |
$1,018.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$792.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$849.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$962.20
|
| Rate for Payer: PHP Commercial |
$962.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: Priority Health SBD |
$713.16
|
| Rate for Payer: UMR Bronson Commercial |
$498.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$849.00
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$747.60 |
| Rate for Payer: Aetna Commercial |
$438.57
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.72
|
| Rate for Payer: Priority Health Narrow Network |
$513.72
|
| Rate for Payer: Priority Health SBD |
$513.72
|
| Rate for Payer: UMR Bronson Commercial |
$491.28
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,068.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$747.60 |
| Rate for Payer: Aetna Commercial |
$438.57
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.72
|
| Rate for Payer: Priority Health Narrow Network |
$513.72
|
| Rate for Payer: Priority Health SBD |
$513.72
|
| Rate for Payer: UMR Bronson Commercial |
$491.28
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
IP
|
$1,068.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$469.92 |
| Max. Negotiated Rate |
$961.20 |
| Rate for Payer: Aetna American Axle |
$694.20
|
| Rate for Payer: Aetna Commercial |
$907.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.20
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$747.60
|
| Rate for Payer: Cofinity Commercial |
$918.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.40
|
| Rate for Payer: Healthscope Commercial |
$961.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$747.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$907.80
|
| Rate for Payer: PHP Commercial |
$907.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.60
|
| Rate for Payer: Priority Health SBD |
$672.84
|
| Rate for Payer: UMR Bronson Commercial |
$469.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.00
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
OP
|
$1,068.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$333.99 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$694.20
|
| Rate for Payer: Aetna Commercial |
$907.80
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.20
|
| 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 |
$1,452.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$918.48
|
| Rate for Payer: Cofinity Commercial |
$747.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$961.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$747.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.00
|
| 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 |
$907.80
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$907.80
|
| 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 |
$747.60
|
| 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 |
$672.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$333.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$395.16
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.00
|
|
|
PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$1,647.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$1,152.90 |
| Rate for Payer: Aetna Commercial |
$697.72
|
| Rate for Payer: BCBS Complete |
$358.96
|
| Rate for Payer: BCBS Trust/PPO |
$149.00
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Cash Price |
$1,317.60
|
| Rate for Payer: Meridian Medicaid |
$358.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,152.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.43
|
| Rate for Payer: Priority Health Narrow Network |
$811.43
|
| Rate for Payer: Priority Health SBD |
$811.43
|
| Rate for Payer: UMR Bronson Commercial |
$757.62
|
|
|
PR EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR
|
Professional
|
Both
|
$5,428.00
|
|
|
Service Code
|
HCPCS 51500
|
| Min. Negotiated Rate |
$406.62 |
| Max. Negotiated Rate |
$3,799.60 |
| Rate for Payer: Aetna Commercial |
$817.18
|
| Rate for Payer: BCBS Complete |
$426.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,025.57
|
| Rate for Payer: Cash Price |
$4,342.40
|
| Rate for Payer: Cash Price |
$4,342.40
|
| Rate for Payer: Meridian Medicaid |
$426.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,799.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,018.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,018.03
|
| Rate for Payer: Priority Health SBD |
$1,018.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,496.88
|
|
|
PR EXC URETHRAL DIVERTICULUM SPX FEMALE
|
Professional
|
Both
|
$1,126.00
|
|
|
Service Code
|
HCPCS 53230
|
| Min. Negotiated Rate |
$52.30 |
| Max. Negotiated Rate |
$975.34 |
| Rate for Payer: Aetna Commercial |
$782.17
|
| Rate for Payer: BCBS Complete |
$409.28
|
| Rate for Payer: BCBS Trust/PPO |
$52.30
|
| Rate for Payer: Cash Price |
$900.80
|
| Rate for Payer: Cash Price |
$900.80
|
| Rate for Payer: Meridian Medicaid |
$409.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$975.34
|
| Rate for Payer: Priority Health Narrow Network |
$975.34
|
| Rate for Payer: Priority Health SBD |
$975.34
|
| Rate for Payer: UMR Bronson Commercial |
$517.96
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL
|
Professional
|
Both
|
$2,101.00
|
|
|
Service Code
|
HCPCS 55535
|
| Min. Negotiated Rate |
$275.84 |
| Max. Negotiated Rate |
$1,511.99 |
| Rate for Payer: Aetna Commercial |
$551.00
|
| Rate for Payer: BCBS Complete |
$289.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,511.99
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Cash Price |
$1,680.80
|
| Rate for Payer: Meridian Medicaid |
$289.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.50
|
| Rate for Payer: Priority Health Narrow Network |
$689.50
|
| Rate for Payer: Priority Health SBD |
$689.50
|
| Rate for Payer: UMR Bronson Commercial |
$966.46
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX
|
Professional
|
Both
|
$642.00
|
|
|
Service Code
|
HCPCS 55530
|
| Min. Negotiated Rate |
$225.99 |
| Max. Negotiated Rate |
$1,577.50 |
| Rate for Payer: Aetna Commercial |
$450.95
|
| Rate for Payer: BCBS Complete |
$237.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.50
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Meridian Medicaid |
$237.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.67
|
| Rate for Payer: Priority Health Narrow Network |
$564.67
|
| Rate for Payer: Priority Health SBD |
$564.67
|
| Rate for Payer: UMR Bronson Commercial |
$295.32
|
|
|
PR EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR
|
Professional
|
Both
|
$776.00
|
|
|
Service Code
|
HCPCS 55540
|
| Min. Negotiated Rate |
$356.96 |
| Max. Negotiated Rate |
$1,332.37 |
| Rate for Payer: Aetna Commercial |
$718.72
|
| Rate for Payer: BCBS Complete |
$375.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,332.37
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Cash Price |
$620.80
|
| Rate for Payer: Meridian Medicaid |
$375.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$900.24
|
| Rate for Payer: Priority Health Narrow Network |
$900.24
|
| Rate for Payer: Priority Health SBD |
$900.24
|
| Rate for Payer: UMR Bronson Commercial |
$356.96
|
|
|
PR EXC XTRPARENCHYMAL LESION TESTIS
|
Professional
|
Both
|
$1,090.00
|
|
|
Service Code
|
HCPCS 54512
|
| Min. Negotiated Rate |
$343.57 |
| Max. Negotiated Rate |
$1,954.18 |
| Rate for Payer: Aetna Commercial |
$692.89
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,954.18
|
| Rate for Payer: Cash Price |
$872.00
|
| Rate for Payer: Cash Price |
$872.00
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$858.63
|
| Rate for Payer: Priority Health Narrow Network |
$858.63
|
| Rate for Payer: Priority Health SBD |
$858.63
|
| Rate for Payer: UMR Bronson Commercial |
$501.40
|
|
