|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| 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: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,963.49
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,170.85
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,536.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.27 |
| Max. Negotiated Rate |
$3,618.87 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,949.02
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 22902
|
| Hospital Charge Code |
76100277
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
IP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,320.50 |
| Max. Negotiated Rate |
$3,570.00 |
| Rate for Payer: Aetna Commercial |
$3,213.00
|
| Rate for Payer: ASR ASR |
$3,462.90
|
| Rate for Payer: ASR Commercial |
$3,462.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,909.19
|
| Rate for Payer: BCN Commercial |
$2,767.82
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,355.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Healthscope Commercial |
$3,570.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,462.90
|
| Rate for Payer: Mclaren Commercial |
$3,213.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: Nomi Health Commercial |
$2,927.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.60
|
|
|
HC EXC TUMOR SOFT TISSUE ABD WALL, SQ <5CM
|
Facility
|
OP
|
$3,570.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
76100398
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$3,213.00
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| 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: ASR ASR |
$3,462.90
|
| Rate for Payer: ASR Commercial |
$3,462.90
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,923.47
|
| Rate for Payer: BCN Commercial |
$2,767.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,355.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,570.00
|
| Rate for Payer: Healthscope Whirlpool |
$3,462.90
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$3,213.00
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.50
|
| Rate for Payer: Nomi Health Commercial |
$2,927.40
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,128.03
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,502.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,141.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SQ < 3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 21930
|
| Hospital Charge Code |
76100227
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,618.87
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| 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: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,963.49
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,170.85
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,536.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXC TUMOR SOFT TISSUE, BACK/FLANK, SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,618.87
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
76100268
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.27 |
| Max. Negotiated Rate |
$3,618.87 |
| Rate for Payer: Aetna Commercial |
$3,256.98
|
| Rate for Payer: ASR ASR |
$3,510.30
|
| Rate for Payer: ASR Commercial |
$3,510.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,949.02
|
| Rate for Payer: BCN Commercial |
$2,805.71
|
| Rate for Payer: Cash Price |
$2,895.10
|
| Rate for Payer: Cofinity Commercial |
$3,401.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,895.10
|
| Rate for Payer: Healthscope Commercial |
$3,618.87
|
| Rate for Payer: Healthscope Whirlpool |
$3,510.30
|
| Rate for Payer: Mclaren Commercial |
$3,256.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,076.04
|
| Rate for Payer: Nomi Health Commercial |
$2,967.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.61
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
OP
|
$2,427.69
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$2,184.92
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$2,354.86
|
| Rate for Payer: ASR Commercial |
$2,354.86
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,988.04
|
| Rate for Payer: BCN Commercial |
$1,882.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,942.15
|
| Rate for Payer: Cash Price |
$1,942.15
|
| Rate for Payer: Cofinity Commercial |
$2,282.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,942.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,427.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,354.86
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$2,184.92
|
| 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: Multiplan/Beech St/PHCS Commercial |
$2,063.54
|
| Rate for Payer: Nomi Health Commercial |
$1,990.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,127.14
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,701.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,136.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE BACK/FLANK SUBQ >3CM
|
Facility
|
IP
|
$2,427.69
|
|
|
Service Code
|
CPT 21931
|
| Hospital Charge Code |
76100244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,578.00 |
| Max. Negotiated Rate |
$2,427.69 |
| Rate for Payer: Aetna Commercial |
$2,184.92
|
| Rate for Payer: ASR ASR |
$2,354.86
|
| Rate for Payer: ASR Commercial |
$2,354.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,978.32
|
| Rate for Payer: BCN Commercial |
$1,882.19
|
| Rate for Payer: Cash Price |
$1,942.15
|
| Rate for Payer: Cofinity Commercial |
$2,282.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,942.15
|
| Rate for Payer: Healthscope Commercial |
$2,427.69
|
| Rate for Payer: Healthscope Whirlpool |
$2,354.86
|
| Rate for Payer: Mclaren Commercial |
$2,184.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,063.54
|
| Rate for Payer: Nomi Health Commercial |
$1,990.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,136.37
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
IP
|
$4,438.35
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,884.93 |
| Max. Negotiated Rate |
$4,438.35 |
| Rate for Payer: Aetna Commercial |
$3,994.52
|
| Rate for Payer: ASR ASR |
$4,305.20
|
| Rate for Payer: ASR Commercial |
$4,305.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,616.81
|
| Rate for Payer: BCN Commercial |
$3,441.05
|
| Rate for Payer: Cash Price |
$3,550.68
|
| Rate for Payer: Cofinity Commercial |
$4,172.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,550.68
|
| Rate for Payer: Healthscope Commercial |
$4,438.35
|
| Rate for Payer: Healthscope Whirlpool |
$4,305.20
|
| Rate for Payer: Mclaren Commercial |
$3,994.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,772.60
|
| Rate for Payer: Nomi Health Commercial |
$3,639.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,884.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,905.75
|
|
|
HC EXC TUMOR SOFT TISSUE FACE SCALP SUBQ <2CM
|
Facility
|
OP
|
$4,438.35
|
|
|
Service Code
|
CPT 21011
|
| Hospital Charge Code |
76100323
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,438.35 |
| Rate for Payer: Aetna Commercial |
$3,994.52
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$4,305.20
|
| Rate for Payer: ASR Commercial |
$4,305.20
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,634.56
|
| Rate for Payer: BCN Commercial |
$3,441.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,550.68
|
| Rate for Payer: Cash Price |
$3,550.68
|
| Rate for Payer: Cofinity Commercial |
$4,172.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,550.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,438.35
|
| Rate for Payer: Healthscope Whirlpool |
$4,305.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,994.52
|
| 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: Multiplan/Beech St/PHCS Commercial |
$3,772.60
|
| Rate for Payer: Nomi Health Commercial |
$3,639.45
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,884.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,888.88
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,111.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,905.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE FACE/SCALP, SUBQ 2CM OR >
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 21012
|
| Hospital Charge Code |
76100246
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM DEEP<3CM
|
Facility
|
OP
|
$4,281.96
|
|
|
Service Code
|
CPT 25076
|
| Hospital Charge Code |
76100515
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$4,281.96 |
| Rate for Payer: Aetna Commercial |
$3,853.76
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$4,153.50
|
| Rate for Payer: ASR Commercial |
$4,153.50
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,506.50
|
| Rate for Payer: BCN Commercial |
$3,319.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$3,425.57
|
| Rate for Payer: Cash Price |
$3,425.57
|
| Rate for Payer: Cofinity Commercial |
$4,025.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,425.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$4,281.96
|
| Rate for Payer: Healthscope Whirlpool |
$4,153.50
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$3,853.76
|
| 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: Multiplan/Beech St/PHCS Commercial |
$3,639.67
|
| Rate for Payer: Nomi Health Commercial |
$3,511.21
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,751.85
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,001.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,768.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM DEEP<3CM
|
Facility
|
IP
|
$4,281.96
|
|
|
Service Code
|
CPT 25076
|
| Hospital Charge Code |
76100515
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,783.27 |
| Max. Negotiated Rate |
$4,281.96 |
| Rate for Payer: Aetna Commercial |
$3,853.76
|
| Rate for Payer: ASR ASR |
$4,153.50
|
| Rate for Payer: ASR Commercial |
$4,153.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,489.37
|
| Rate for Payer: BCN Commercial |
$3,319.80
|
| Rate for Payer: Cash Price |
$3,425.57
|
| Rate for Payer: Cofinity Commercial |
$4,025.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,425.57
|
| Rate for Payer: Healthscope Commercial |
$4,281.96
|
| Rate for Payer: Healthscope Whirlpool |
$4,153.50
|
| Rate for Payer: Mclaren Commercial |
$3,853.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,639.67
|
| Rate for Payer: Nomi Health Commercial |
$3,511.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,768.12
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM/WRIST, SQ <3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
76100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,876.89
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,501.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE FOREARM/WRIST, SQ <3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
76100255
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC EXC TUMOR SOFT TISSUE LEG/ANKLE SQ 3 CM/>
|
Facility
|
IP
|
$3,945.20
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
76100312
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,564.38 |
| Max. Negotiated Rate |
$3,945.20 |
| Rate for Payer: Aetna Commercial |
$3,550.68
|
| Rate for Payer: ASR ASR |
$3,826.84
|
| Rate for Payer: ASR Commercial |
$3,826.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,214.94
|
| Rate for Payer: BCN Commercial |
$3,058.71
|
| Rate for Payer: Cash Price |
$3,156.16
|
| Rate for Payer: Cofinity Commercial |
$3,708.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.16
|
| Rate for Payer: Healthscope Commercial |
$3,945.20
|
| Rate for Payer: Healthscope Whirlpool |
$3,826.84
|
| Rate for Payer: Mclaren Commercial |
$3,550.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,353.42
|
| Rate for Payer: Nomi Health Commercial |
$3,235.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,471.78
|
|
|
HC EXC TUMOR SOFT TISSUE LEG/ANKLE SQ 3 CM/>
|
Facility
|
OP
|
$3,945.20
|
|
|
Service Code
|
CPT 27632
|
| Hospital Charge Code |
76100312
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,503.04 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$3,550.68
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| 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: ASR ASR |
$3,826.84
|
| Rate for Payer: ASR Commercial |
$3,826.84
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,230.72
|
| Rate for Payer: BCN Commercial |
$3,058.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$3,156.16
|
| Rate for Payer: Cash Price |
$3,156.16
|
| Rate for Payer: Cofinity Commercial |
$3,708.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,945.20
|
| Rate for Payer: Healthscope Whirlpool |
$3,826.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$3,550.68
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,353.42
|
| Rate for Payer: Nomi Health Commercial |
$3,235.06
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,456.78
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$2,765.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,471.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXC TUMOR SOFT TISSUE,NECK/ANT THORAX, SQ <3CM
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
76100264
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$2,142.08 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.58
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
|
|
HC EXC TUMOR SOFT TISSUE,NECK/ANT THORAX, SQ <3CM
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
76100264
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$850.89 |
| Max. Negotiated Rate |
$3,486.93 |
| Rate for Payer: Aetna Commercial |
$1,927.87
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| 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: ASR ASR |
$2,077.82
|
| Rate for Payer: ASR Commercial |
$2,077.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.15
|
| Rate for Payer: BCN Commercial |
$1,660.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$2,013.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,142.08
|
| Rate for Payer: Healthscope Whirlpool |
$2,077.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,927.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,486.93
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,789.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,885.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXC TUMOR SOFT TISSUE, NECK/ANT THORAX, SQ, 3CM OR >
|
Facility
|
IP
|
$3,618.51
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
76100291
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,352.03 |
| Max. Negotiated Rate |
$3,618.51 |
| Rate for Payer: Aetna Commercial |
$3,256.66
|
| Rate for Payer: ASR ASR |
$3,509.95
|
| Rate for Payer: ASR Commercial |
$3,509.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,948.72
|
| Rate for Payer: BCN Commercial |
$2,805.43
|
| Rate for Payer: Cash Price |
$2,894.81
|
| Rate for Payer: Cofinity Commercial |
$3,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,894.81
|
| Rate for Payer: Healthscope Commercial |
$3,618.51
|
| Rate for Payer: Healthscope Whirlpool |
$3,509.95
|
| Rate for Payer: Mclaren Commercial |
$3,256.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,075.73
|
| Rate for Payer: Nomi Health Commercial |
$2,967.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,352.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,184.29
|
|
