|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
IP
|
$1,767.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$1,236.90 |
| Max. Negotiated Rate |
$1,767.00 |
| Rate for Payer: Aetna Commercial |
$1,590.30
|
| Rate for Payer: ASR ASR |
$1,713.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.96
|
| Rate for Payer: BCN Commercial |
$1,369.96
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$1,660.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,413.60
|
| Rate for Payer: Healthscope Commercial |
$1,767.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,713.99
|
| Rate for Payer: Mclaren Commercial |
$1,590.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,501.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,554.96
|
|
|
PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA
|
Facility
|
OP
|
$1,767.00
|
|
|
Service Code
|
CPT 25109
|
| Hospital Charge Code |
25109
|
| Min. Negotiated Rate |
$1,236.90 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$1,590.30
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$1,713.99
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.96
|
| Rate for Payer: BCN Commercial |
$1,369.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cash Price |
$1,413.60
|
| Rate for Payer: Cofinity Commercial |
$1,660.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,413.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,767.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,713.99
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$1,590.30
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,501.95
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,236.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,607.97
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,554.96
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR EXC THROMBOSED HEMORRHOID XTRNL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 46320
|
| Min. Negotiated Rate |
$73.06 |
| Max. Negotiated Rate |
$2,226.78 |
| Rate for Payer: Aetna Commercial |
$148.47
|
| Rate for Payer: Aetna Medicare |
$110.80
|
| Rate for Payer: BCBS Complete |
$76.71
|
| Rate for Payer: BCBS MAPPO |
$110.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.78
|
| Rate for Payer: BCN Commercial |
$314.22
|
| Rate for Payer: BCN Medicare Advantage |
$110.80
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$148.47
|
| Rate for Payer: Cofinity Commercial |
$159.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.80
|
| Rate for Payer: Healthscope Commercial |
$132.96
|
| Rate for Payer: Healthscope Whirlpool |
$132.96
|
| Rate for Payer: Meridian Medicaid |
$76.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.34
|
| Rate for Payer: PACE SWMI |
$110.80
|
| Rate for Payer: PHP Medicare Advantage |
$110.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.74
|
| Rate for Payer: Priority Health Medicare |
$110.80
|
| Rate for Payer: Priority Health Narrow Network |
$198.74
|
| Rate for Payer: UHC Medicare Advantage |
$114.12
|
|
|
PR EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 15950
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$833.86
|
| Rate for Payer: Aetna Medicare |
$622.28
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$622.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$933.86
|
| Rate for Payer: BCN Medicare Advantage |
$622.28
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$833.86
|
| Rate for Payer: Cofinity Commercial |
$896.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.28
|
| Rate for Payer: Healthscope Commercial |
$746.74
|
| Rate for Payer: Healthscope Whirlpool |
$746.74
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$653.39
|
| Rate for Payer: PACE SWMI |
$622.28
|
| Rate for Payer: PHP Medicare Advantage |
$622.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$785.49
|
| Rate for Payer: Priority Health Medicare |
$622.28
|
| Rate for Payer: Priority Health Narrow Network |
$785.49
|
| Rate for Payer: UHC Medicare Advantage |
$640.95
|
|
|
PR EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN
|
Professional
|
Both
|
$1,956.00
|
|
|
Service Code
|
HCPCS 15956
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$1,702.06 |
| Rate for Payer: Aetna Commercial |
$1,533.04
|
| Rate for Payer: Aetna Medicare |
$1,144.06
|
| Rate for Payer: BCBS Complete |
$797.98
|
| Rate for Payer: BCBS MAPPO |
$1,144.06
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$1,702.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,144.06
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cash Price |
$1,564.80
|
| Rate for Payer: Cofinity Commercial |
$1,533.04
|
| Rate for Payer: Cofinity Commercial |
$1,647.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,144.06
|
| Rate for Payer: Healthscope Commercial |
$1,372.87
|
| Rate for Payer: Healthscope Whirlpool |
$1,372.87
|
| Rate for Payer: Meridian Medicaid |
$797.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,201.26
|
| Rate for Payer: PACE SWMI |
$1,144.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,144.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,369.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,431.65
|
| Rate for Payer: Priority Health Medicare |
$1,144.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,431.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,178.38
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,528.80 |
| Rate for Payer: Aetna Commercial |
$709.84
|
| Rate for Payer: Aetna Medicare |
$529.73
|
| Rate for Payer: BCBS Complete |
$365.22
|
| Rate for Payer: BCBS MAPPO |
$529.73
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$529.73
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$762.81
|
| Rate for Payer: Cofinity Commercial |
$709.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.73
|
| Rate for Payer: Healthscope Commercial |
$635.68
|
| Rate for Payer: Healthscope Whirlpool |
$635.68
|
| Rate for Payer: Meridian Medicaid |
$365.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.22
|
| Rate for Payer: PACE SWMI |
$529.73
|
| Rate for Payer: PHP Medicare Advantage |
$529.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.25
|
| Rate for Payer: Priority Health Medicare |
$529.73
|
| Rate for Payer: Priority Health Narrow Network |
$827.25
|
| Rate for Payer: UHC Medicare Advantage |
$545.62
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
IP
|
$2,184.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$1,528.80 |
| Max. Negotiated Rate |
$2,184.00 |
| Rate for Payer: Aetna Commercial |
$1,965.60
|
| Rate for Payer: ASR ASR |
$2,118.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.26
|
| Rate for Payer: BCN Commercial |
$1,693.26
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$2,052.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.20
|
| Rate for Payer: Healthscope Commercial |
$2,184.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,118.48
|
| Rate for Payer: Mclaren Commercial |
$1,965.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,856.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,921.92
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 25073
|
| Min. Negotiated Rate |
$221.36 |
| Max. Negotiated Rate |
$1,528.80 |
| Rate for Payer: Aetna Commercial |
$709.84
|
| Rate for Payer: Aetna Medicare |
$529.73
|
| Rate for Payer: BCBS Complete |
$365.22
|
| Rate for Payer: BCBS MAPPO |
$529.73
|
| Rate for Payer: BCBS Trust/PPO |
$221.36
|
| Rate for Payer: BCN Commercial |
$791.66
|
| Rate for Payer: BCN Medicare Advantage |
$529.73
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$762.81
|
| Rate for Payer: Cofinity Commercial |
$709.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.73
|
| Rate for Payer: Healthscope Commercial |
$635.68
|
| Rate for Payer: Healthscope Whirlpool |
$635.68
|
| Rate for Payer: Meridian Medicaid |
$365.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$556.22
|
| Rate for Payer: PACE SWMI |
$529.73
|
| Rate for Payer: PHP Medicare Advantage |
$529.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.25
|
| Rate for Payer: Priority Health Medicare |
$529.73
|
| Rate for Payer: Priority Health Narrow Network |
$827.25
|
| Rate for Payer: UHC Medicare Advantage |
$545.62
|
|
|
PR EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>
|
Facility
|
OP
|
$2,184.00
|
|
|
Service Code
|
CPT 25073
|
| Hospital Charge Code |
25073
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,965.60
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| 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: ASR ASR |
$2,118.48
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.26
|
| Rate for Payer: BCN Commercial |
$1,693.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$2,052.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$2,184.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,118.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,965.60
|
| 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 |
$1,856.40
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| 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 |
$1,528.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,987.44
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,921.92
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,209.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$846.30 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,088.10
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| 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: ASR ASR |
$1,172.73
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$937.34
|
| Rate for Payer: BCN Commercial |
$937.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$1,136.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,209.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,172.73
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,088.10
|
| 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 |
$1,027.65
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| 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 |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.19
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$858.39
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.92
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$593.30
|
| Rate for Payer: Aetna Medicare |
$442.76
|
| Rate for Payer: BCBS Complete |
$303.27
|
| Rate for Payer: BCBS MAPPO |
$442.76
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$442.76
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$637.57
|
| Rate for Payer: Cofinity Commercial |
$593.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.76
|
| Rate for Payer: Healthscope Commercial |
$531.31
|
| Rate for Payer: Healthscope Whirlpool |
$531.31
|
| Rate for Payer: Meridian Medicaid |
$303.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.90
|
| Rate for Payer: PACE SWMI |
$442.76
|
| Rate for Payer: PHP Medicare Advantage |
$442.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.31
|
| Rate for Payer: Priority Health Medicare |
$442.76
|
| Rate for Payer: Priority Health Narrow Network |
$686.31
|
| Rate for Payer: UHC Medicare Advantage |
$456.04
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,209.00
|
|
|
Service Code
|
HCPCS 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$593.30
|
| Rate for Payer: Aetna Medicare |
$442.76
|
| Rate for Payer: BCBS Complete |
$303.27
|
| Rate for Payer: BCBS MAPPO |
$442.76
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: BCN Medicare Advantage |
$442.76
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$593.30
|
| Rate for Payer: Cofinity Commercial |
$637.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.76
|
| Rate for Payer: Healthscope Commercial |
$531.31
|
| Rate for Payer: Healthscope Whirlpool |
$531.31
|
| Rate for Payer: Meridian Medicaid |
$303.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.90
|
| Rate for Payer: PACE SWMI |
$442.76
|
| Rate for Payer: PHP Medicare Advantage |
$442.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.31
|
| Rate for Payer: Priority Health Medicare |
$442.76
|
| Rate for Payer: Priority Health Narrow Network |
$686.31
|
| Rate for Payer: UHC Medicare Advantage |
$456.04
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,209.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$846.30 |
| Max. Negotiated Rate |
$1,209.00 |
| Rate for Payer: Aetna Commercial |
$1,088.10
|
| Rate for Payer: ASR ASR |
$1,172.73
|
| Rate for Payer: BCBS Trust/PPO |
$937.34
|
| Rate for Payer: BCN Commercial |
$937.34
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cofinity Commercial |
$1,136.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.20
|
| Rate for Payer: Healthscope Commercial |
$1,209.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,172.73
|
| Rate for Payer: Mclaren Commercial |
$1,088.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,027.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,063.92
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,162.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$813.40 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,045.80
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| 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: ASR ASR |
$1,127.14
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$900.90
|
| Rate for Payer: BCN Commercial |
$900.90
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$1,092.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,162.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,045.80
|
| 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 |
$987.70
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| 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 |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$825.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,162.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$813.40 |
| Max. Negotiated Rate |
$1,162.00 |
| Rate for Payer: Aetna Commercial |
$1,045.80
|
| Rate for Payer: ASR ASR |
$1,127.14
|
| Rate for Payer: BCBS Trust/PPO |
$900.90
|
| Rate for Payer: BCN Commercial |
$900.90
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$1,092.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.60
|
| Rate for Payer: Healthscope Commercial |
$1,162.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,127.14
|
| Rate for Payer: Mclaren Commercial |
$1,045.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$987.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,022.56
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,131.09 |
| Rate for Payer: Aetna Commercial |
$980.37
|
| Rate for Payer: Aetna Medicare |
$731.62
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$731.62
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$731.62
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$980.37
|
| Rate for Payer: Cofinity Commercial |
$1,053.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.62
|
| Rate for Payer: Healthscope Commercial |
$877.94
|
| Rate for Payer: Healthscope Whirlpool |
$877.94
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.20
|
| Rate for Payer: PACE SWMI |
$731.62
|
| Rate for Payer: PHP Medicare Advantage |
$731.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.09
|
| Rate for Payer: Priority Health Medicare |
$731.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.09
|
| Rate for Payer: UHC Medicare Advantage |
$753.57
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,162.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$1,131.09 |
| Rate for Payer: Aetna Commercial |
$980.37
|
| Rate for Payer: Aetna Medicare |
$731.62
|
| Rate for Payer: BCBS Complete |
$498.52
|
| Rate for Payer: BCBS MAPPO |
$731.62
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$1,082.42
|
| Rate for Payer: BCN Medicare Advantage |
$731.62
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cash Price |
$929.60
|
| Rate for Payer: Cofinity Commercial |
$1,053.53
|
| Rate for Payer: Cofinity Commercial |
$980.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.62
|
| Rate for Payer: Healthscope Commercial |
$877.94
|
| Rate for Payer: Healthscope Whirlpool |
$877.94
|
| Rate for Payer: Meridian Medicaid |
$498.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$768.20
|
| Rate for Payer: PACE SWMI |
$731.62
|
| Rate for Payer: PHP Medicare Advantage |
$731.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$474.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,131.09
|
| Rate for Payer: Priority Health Medicare |
$731.62
|
| Rate for Payer: Priority Health Narrow Network |
$1,131.09
|
| Rate for Payer: UHC Medicare Advantage |
$753.57
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,975.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,381.58 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,777.50
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| 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: ASR ASR |
$1,915.75
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.22
|
| Rate for Payer: BCN Commercial |
$1,531.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$1,856.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,975.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,915.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,777.50
|
| 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 |
$1,678.75
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| 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 |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.25
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,975.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,382.50 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$1,777.50
|
| Rate for Payer: ASR ASR |
$1,915.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.22
|
| Rate for Payer: BCN Commercial |
$1,531.22
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$1,856.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,580.00
|
| Rate for Payer: Healthscope Commercial |
$1,975.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,915.75
|
| Rate for Payer: Mclaren Commercial |
$1,777.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,678.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,738.00
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,975.00
|
|
|
Service Code
|
HCPCS 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,382.50 |
| Rate for Payer: Aetna Commercial |
$882.91
|
| Rate for Payer: Aetna Medicare |
$658.89
|
| Rate for Payer: BCBS Complete |
$448.19
|
| Rate for Payer: BCBS MAPPO |
$658.89
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$658.89
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$948.80
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.89
|
| Rate for Payer: Healthscope Commercial |
$790.67
|
| Rate for Payer: Healthscope Whirlpool |
$790.67
|
| Rate for Payer: Meridian Medicaid |
$448.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$691.83
|
| Rate for Payer: PACE SWMI |
$658.89
|
| Rate for Payer: PHP Medicare Advantage |
$658.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.28
|
| Rate for Payer: Priority Health Medicare |
$658.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.28
|
| Rate for Payer: UHC Medicare Advantage |
$678.66
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,975.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,382.50 |
| Rate for Payer: Aetna Commercial |
$882.91
|
| Rate for Payer: Aetna Medicare |
$658.89
|
| Rate for Payer: BCBS Complete |
$448.19
|
| Rate for Payer: BCBS MAPPO |
$658.89
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: BCN Medicare Advantage |
$658.89
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cash Price |
$1,580.00
|
| Rate for Payer: Cofinity Commercial |
$882.91
|
| Rate for Payer: Cofinity Commercial |
$948.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.89
|
| Rate for Payer: Healthscope Commercial |
$790.67
|
| Rate for Payer: Healthscope Whirlpool |
$790.67
|
| Rate for Payer: Meridian Medicaid |
$448.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$691.83
|
| Rate for Payer: PACE SWMI |
$658.89
|
| Rate for Payer: PHP Medicare Advantage |
$658.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,382.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,020.28
|
| Rate for Payer: Priority Health Medicare |
$658.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,020.28
|
| Rate for Payer: UHC Medicare Advantage |
$678.66
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
OP
|
$866.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$606.20 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$779.40
|
| Rate for Payer: Aetna Medicare |
$2,525.74
|
| 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: ASR ASR |
$840.02
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$671.41
|
| Rate for Payer: BCN Commercial |
$671.41
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$814.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$866.00
|
| Rate for Payer: Healthscope Whirlpool |
$840.02
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$779.40
|
| 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 |
$736.10
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,778.31
|
| Rate for Payer: PHP Medicaid |
$1,381.58
|
| 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 |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.06
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$614.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$762.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$866.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$336.11 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$687.76
|
| Rate for Payer: Aetna Medicare |
$513.25
|
| Rate for Payer: BCBS Complete |
$352.92
|
| Rate for Payer: BCBS MAPPO |
$513.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$513.25
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$739.08
|
| Rate for Payer: Cofinity Commercial |
$687.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.25
|
| Rate for Payer: Healthscope Commercial |
$615.90
|
| Rate for Payer: Healthscope Whirlpool |
$615.90
|
| Rate for Payer: Meridian Medicaid |
$352.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$538.91
|
| Rate for Payer: PACE SWMI |
$513.25
|
| Rate for Payer: PHP Medicare Advantage |
$513.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$801.21
|
| Rate for Payer: Priority Health Medicare |
$513.25
|
| Rate for Payer: Priority Health Narrow Network |
$801.21
|
| Rate for Payer: UHC Medicare Advantage |
$528.65
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$866.00
|
|
|
Service Code
|
HCPCS 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$336.11 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$687.76
|
| Rate for Payer: Aetna Medicare |
$513.25
|
| Rate for Payer: BCBS Complete |
$352.92
|
| Rate for Payer: BCBS MAPPO |
$513.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: BCN Medicare Advantage |
$513.25
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$739.08
|
| Rate for Payer: Cofinity Commercial |
$687.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.25
|
| Rate for Payer: Healthscope Commercial |
$615.90
|
| Rate for Payer: Healthscope Whirlpool |
$615.90
|
| Rate for Payer: Meridian Medicaid |
$352.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$538.91
|
| Rate for Payer: PACE SWMI |
$513.25
|
| Rate for Payer: PHP Medicare Advantage |
$513.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$801.21
|
| Rate for Payer: Priority Health Medicare |
$513.25
|
| Rate for Payer: Priority Health Narrow Network |
$801.21
|
| Rate for Payer: UHC Medicare Advantage |
$528.65
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
IP
|
$866.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$606.20 |
| Max. Negotiated Rate |
$866.00 |
| Rate for Payer: Aetna Commercial |
$779.40
|
| Rate for Payer: ASR ASR |
$840.02
|
| Rate for Payer: BCBS Trust/PPO |
$671.41
|
| Rate for Payer: BCN Commercial |
$671.41
|
| Rate for Payer: Cash Price |
$692.80
|
| Rate for Payer: Cofinity Commercial |
$814.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.80
|
| Rate for Payer: Healthscope Commercial |
$866.00
|
| Rate for Payer: Healthscope Whirlpool |
$840.02
|
| Rate for Payer: Mclaren Commercial |
$779.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$762.08
|
|
