|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$1,089.20 |
| Rate for Payer: Aetna Commercial |
$923.96
|
| Rate for Payer: Aetna Medicare |
$689.52
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS MAPPO |
$689.52
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: BCN Medicare Advantage |
$689.52
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$992.91
|
| Rate for Payer: Cofinity Commercial |
$923.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.52
|
| Rate for Payer: Healthscope Commercial |
$827.42
|
| Rate for Payer: Healthscope Whirlpool |
$827.42
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$724.00
|
| Rate for Payer: PACE SWMI |
$689.52
|
| Rate for Payer: PHP Medicare Advantage |
$689.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,069.30
|
| Rate for Payer: Priority Health Medicare |
$689.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.30
|
| Rate for Payer: UHC Medicare Advantage |
$710.21
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,556.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$449.43 |
| Max. Negotiated Rate |
$1,089.20 |
| Rate for Payer: Aetna Commercial |
$923.96
|
| Rate for Payer: Aetna Medicare |
$689.52
|
| Rate for Payer: BCBS Complete |
$471.90
|
| Rate for Payer: BCBS MAPPO |
$689.52
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: BCN Medicare Advantage |
$689.52
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$992.91
|
| Rate for Payer: Cofinity Commercial |
$923.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.52
|
| Rate for Payer: Healthscope Commercial |
$827.42
|
| Rate for Payer: Healthscope Whirlpool |
$827.42
|
| Rate for Payer: Meridian Medicaid |
$471.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$724.00
|
| Rate for Payer: PACE SWMI |
$689.52
|
| Rate for Payer: PHP Medicare Advantage |
$689.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,069.30
|
| Rate for Payer: Priority Health Medicare |
$689.52
|
| Rate for Payer: Priority Health Narrow Network |
$1,069.30
|
| Rate for Payer: UHC Medicare Advantage |
$710.21
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,556.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,089.20 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,400.40
|
| 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 |
$1,509.32
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.37
|
| Rate for Payer: BCN Commercial |
$1,206.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$1,462.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,556.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,509.32
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,400.40
|
| 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 |
$1,322.60
|
| 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 |
$1,089.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,415.96
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,104.76
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,369.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,556.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,089.20 |
| Max. Negotiated Rate |
$1,556.00 |
| Rate for Payer: Aetna Commercial |
$1,400.40
|
| Rate for Payer: ASR ASR |
$1,509.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.37
|
| Rate for Payer: BCN Commercial |
$1,206.37
|
| Rate for Payer: Cash Price |
$1,244.80
|
| Rate for Payer: Cofinity Commercial |
$1,462.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.80
|
| Rate for Payer: Healthscope Commercial |
$1,556.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,509.32
|
| Rate for Payer: Mclaren Commercial |
$1,400.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,322.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,369.28
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,212.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$487.13 |
| Max. Negotiated Rate |
$2,248.40 |
| Rate for Payer: Aetna Commercial |
$998.66
|
| Rate for Payer: Aetna Medicare |
$745.27
|
| Rate for Payer: BCBS Complete |
$511.49
|
| Rate for Payer: BCBS MAPPO |
$745.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.52
|
| Rate for Payer: BCN Commercial |
$1,104.90
|
| Rate for Payer: BCN Medicare Advantage |
$745.27
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cofinity Commercial |
$1,073.19
|
| Rate for Payer: Cofinity Commercial |
$998.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$745.27
|
| Rate for Payer: Healthscope Commercial |
$894.32
|
| Rate for Payer: Healthscope Whirlpool |
$894.32
|
| Rate for Payer: Meridian Medicaid |
$511.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$782.53
|
| Rate for Payer: PACE SWMI |
$745.27
|
| Rate for Payer: PHP Medicare Advantage |
$745.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$487.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,248.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.58
|
| Rate for Payer: Priority Health Medicare |
$745.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,154.58
|
| Rate for Payer: UHC Medicare Advantage |
$767.63
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,714.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$403.42 |
| Max. Negotiated Rate |
$1,529.96 |
| Rate for Payer: Aetna Commercial |
$826.70
|
| Rate for Payer: Aetna Medicare |
$616.94
|
| Rate for Payer: BCBS Complete |
$423.59
|
| Rate for Payer: BCBS MAPPO |
$616.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.96
|
| Rate for Payer: BCN Commercial |
$917.25
|
| Rate for Payer: BCN Medicare Advantage |
$616.94
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cash Price |
$1,371.20
|
| Rate for Payer: Cofinity Commercial |
$826.70
|
| Rate for Payer: Cofinity Commercial |
$888.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.94
|
| Rate for Payer: Healthscope Commercial |
$740.33
|
| Rate for Payer: Healthscope Whirlpool |
$740.33
|
| Rate for Payer: Meridian Medicaid |
$423.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.79
|
| Rate for Payer: PACE SWMI |
$616.94
|
| Rate for Payer: PHP Medicare Advantage |
$616.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.49
|
| Rate for Payer: Priority Health Medicare |
$616.94
|
| Rate for Payer: Priority Health Narrow Network |
$958.49
|
| Rate for Payer: UHC Medicare Advantage |
$635.45
|
|
|
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 |
$1,068.20 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,373.40
|
| 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 |
$1,480.22
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.11
|
| Rate for Payer: BCN Commercial |
$1,183.11
|
| 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 |
$1,434.44
|
| 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 |
$1,526.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,480.22
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,373.40
|
| 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 |
$1,297.10
|
| 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 |
$1,068.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,388.66
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,083.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,342.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
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 |
$537.31
|
| Rate for Payer: Aetna Medicare |
$400.98
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$400.98
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$596.19
|
| Rate for Payer: BCN Medicare Advantage |
$400.98
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$537.31
|
| Rate for Payer: Cofinity Commercial |
$577.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.98
|
| Rate for Payer: Healthscope Commercial |
$481.18
|
| Rate for Payer: Healthscope Whirlpool |
$481.18
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.03
|
| Rate for Payer: PACE SWMI |
$400.98
|
| Rate for Payer: PHP Medicare Advantage |
$400.98
|
| 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 Medicare |
$400.98
|
| Rate for Payer: Priority Health Narrow Network |
$622.99
|
| Rate for Payer: UHC Medicare Advantage |
$413.01
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,526.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,068.20 |
| Max. Negotiated Rate |
$1,526.00 |
| Rate for Payer: Aetna Commercial |
$1,373.40
|
| Rate for Payer: ASR ASR |
$1,480.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.11
|
| Rate for Payer: BCN Commercial |
$1,183.11
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$1,434.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,220.80
|
| Rate for Payer: Healthscope Commercial |
$1,526.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,480.22
|
| Rate for Payer: Mclaren Commercial |
$1,373.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,297.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,068.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,342.88
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,526.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$1,068.20 |
| Rate for Payer: Aetna Commercial |
$537.31
|
| Rate for Payer: Aetna Medicare |
$400.98
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$400.98
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$596.19
|
| Rate for Payer: BCN Medicare Advantage |
$400.98
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cash Price |
$1,220.80
|
| Rate for Payer: Cofinity Commercial |
$577.41
|
| Rate for Payer: Cofinity Commercial |
$537.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.98
|
| Rate for Payer: Healthscope Commercial |
$481.18
|
| Rate for Payer: Healthscope Whirlpool |
$481.18
|
| Rate for Payer: Meridian Medicaid |
$275.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.03
|
| Rate for Payer: PACE SWMI |
$400.98
|
| Rate for Payer: PHP Medicare Advantage |
$400.98
|
| 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 Medicare |
$400.98
|
| Rate for Payer: Priority Health Narrow Network |
$622.99
|
| Rate for Payer: UHC Medicare Advantage |
$413.01
|
|
|
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 |
$435.82
|
| Rate for Payer: Aetna Medicare |
$325.24
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$325.24
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$325.24
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$468.35
|
| Rate for Payer: Cofinity Commercial |
$435.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.24
|
| Rate for Payer: Healthscope Commercial |
$390.29
|
| Rate for Payer: Healthscope Whirlpool |
$390.29
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.50
|
| Rate for Payer: PACE SWMI |
$325.24
|
| Rate for Payer: PHP Medicare Advantage |
$325.24
|
| 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 Medicare |
$325.24
|
| Rate for Payer: Priority Health Narrow Network |
$508.61
|
| Rate for Payer: UHC Medicare Advantage |
$335.00
|
|
|
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 |
$890.40 |
| Max. Negotiated Rate |
$1,272.00 |
| Rate for Payer: Aetna Commercial |
$1,144.80
|
| Rate for Payer: ASR ASR |
$1,233.84
|
| Rate for Payer: BCBS Trust/PPO |
$986.18
|
| Rate for Payer: BCN Commercial |
$986.18
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$1,195.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,017.60
|
| Rate for Payer: Healthscope Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,233.84
|
| Rate for Payer: Mclaren Commercial |
$1,144.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,081.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$890.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,119.36
|
|
|
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 |
$435.82
|
| Rate for Payer: Aetna Medicare |
$325.24
|
| Rate for Payer: BCBS Complete |
$224.77
|
| Rate for Payer: BCBS MAPPO |
$325.24
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: BCN Medicare Advantage |
$325.24
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cash Price |
$1,017.60
|
| Rate for Payer: Cofinity Commercial |
$435.82
|
| Rate for Payer: Cofinity Commercial |
$468.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.24
|
| Rate for Payer: Healthscope Commercial |
$390.29
|
| Rate for Payer: Healthscope Whirlpool |
$390.29
|
| Rate for Payer: Meridian Medicaid |
$224.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$341.50
|
| Rate for Payer: PACE SWMI |
$325.24
|
| Rate for Payer: PHP Medicare Advantage |
$325.24
|
| 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 Medicare |
$325.24
|
| Rate for Payer: Priority Health Narrow Network |
$508.61
|
| Rate for Payer: UHC Medicare Advantage |
$335.00
|
|
|
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 |
$788.30 |
| Max. Negotiated Rate |
$2,555.18 |
| Rate for Payer: Aetna Commercial |
$1,144.80
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| 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: ASR ASR |
$1,233.84
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$986.18
|
| Rate for Payer: BCN Commercial |
$986.18
|
| 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 |
$1,195.68
|
| 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 |
$1,272.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,233.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$1,144.80
|
| 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 |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| 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 |
$2,555.18
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$2,044.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,119.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
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 |
$1,162.00 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,494.00
|
| 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 |
$1,610.20
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.00
|
| Rate for Payer: BCN Commercial |
$1,287.00
|
| 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 |
$1,560.40
|
| 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 |
$1,660.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,610.20
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,494.00
|
| 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 |
$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 |
$1,162.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,510.60
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,178.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,460.80
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
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 |
$918.62
|
| Rate for Payer: Aetna Medicare |
$685.54
|
| Rate for Payer: BCBS Complete |
$469.21
|
| Rate for Payer: BCBS MAPPO |
$685.54
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$685.54
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cofinity Commercial |
$987.18
|
| Rate for Payer: Cofinity Commercial |
$918.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.54
|
| Rate for Payer: Healthscope Commercial |
$822.65
|
| Rate for Payer: Healthscope Whirlpool |
$822.65
|
| Rate for Payer: Meridian Medicaid |
$469.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$719.82
|
| Rate for Payer: PACE SWMI |
$685.54
|
| Rate for Payer: PHP Medicare Advantage |
$685.54
|
| 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 Medicare |
$685.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.17
|
| Rate for Payer: UHC Medicare Advantage |
$706.11
|
|
|
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 |
$1,162.00 |
| Max. Negotiated Rate |
$1,660.00 |
| Rate for Payer: Aetna Commercial |
$1,494.00
|
| Rate for Payer: ASR ASR |
$1,610.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.00
|
| Rate for Payer: BCN Commercial |
$1,287.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cofinity Commercial |
$1,560.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.00
|
| Rate for Payer: Healthscope Commercial |
$1,660.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,610.20
|
| Rate for Payer: Mclaren Commercial |
$1,494.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,460.80
|
|
|
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 |
$918.62
|
| Rate for Payer: Aetna Medicare |
$685.54
|
| Rate for Payer: BCBS Complete |
$469.21
|
| Rate for Payer: BCBS MAPPO |
$685.54
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: BCN Medicare Advantage |
$685.54
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cash Price |
$1,328.00
|
| Rate for Payer: Cofinity Commercial |
$918.62
|
| Rate for Payer: Cofinity Commercial |
$987.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.54
|
| Rate for Payer: Healthscope Commercial |
$822.65
|
| Rate for Payer: Healthscope Whirlpool |
$822.65
|
| Rate for Payer: Meridian Medicaid |
$469.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$719.82
|
| Rate for Payer: PACE SWMI |
$685.54
|
| Rate for Payer: PHP Medicare Advantage |
$685.54
|
| 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 Medicare |
$685.54
|
| Rate for Payer: Priority Health Narrow Network |
$1,063.17
|
| Rate for Payer: UHC Medicare Advantage |
$706.11
|
|
|
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 |
$724.46
|
| Rate for Payer: Aetna Medicare |
$540.64
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS MAPPO |
$540.64
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$806.80
|
| Rate for Payer: BCN Medicare Advantage |
$540.64
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$724.46
|
| Rate for Payer: Cofinity Commercial |
$778.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.64
|
| Rate for Payer: Healthscope Commercial |
$648.77
|
| Rate for Payer: Healthscope Whirlpool |
$648.77
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$567.67
|
| Rate for Payer: PACE SWMI |
$540.64
|
| Rate for Payer: PHP Medicare Advantage |
$540.64
|
| 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 Medicare |
$540.64
|
| Rate for Payer: Priority Health Narrow Network |
$843.09
|
| Rate for Payer: UHC Medicare Advantage |
$556.86
|
|
|
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 |
$792.40 |
| Max. Negotiated Rate |
$1,132.00 |
| Rate for Payer: Aetna Commercial |
$1,018.80
|
| Rate for Payer: ASR ASR |
$1,098.04
|
| Rate for Payer: BCBS Trust/PPO |
$877.64
|
| Rate for Payer: BCN Commercial |
$877.64
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$1,064.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$905.60
|
| Rate for Payer: Healthscope Commercial |
$1,132.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,098.04
|
| Rate for Payer: Mclaren Commercial |
$1,018.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$962.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$996.16
|
|
|
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 |
$724.46
|
| Rate for Payer: Aetna Medicare |
$540.64
|
| Rate for Payer: BCBS Complete |
$372.15
|
| Rate for Payer: BCBS MAPPO |
$540.64
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$806.80
|
| Rate for Payer: BCN Medicare Advantage |
$540.64
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cash Price |
$905.60
|
| Rate for Payer: Cofinity Commercial |
$724.46
|
| Rate for Payer: Cofinity Commercial |
$778.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.64
|
| Rate for Payer: Healthscope Commercial |
$648.77
|
| Rate for Payer: Healthscope Whirlpool |
$648.77
|
| Rate for Payer: Meridian Medicaid |
$372.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$567.67
|
| Rate for Payer: PACE SWMI |
$540.64
|
| Rate for Payer: PHP Medicare Advantage |
$540.64
|
| 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 Medicare |
$540.64
|
| Rate for Payer: Priority Health Narrow Network |
$843.09
|
| Rate for Payer: UHC Medicare Advantage |
$556.86
|
|
|
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 |
$792.40 |
| Max. Negotiated Rate |
$3,157.18 |
| Rate for Payer: Aetna Commercial |
$1,018.80
|
| 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 |
$1,098.04
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$877.64
|
| Rate for Payer: BCN Commercial |
$877.64
|
| 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 |
$1,064.08
|
| 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 |
$1,132.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,098.04
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,525.74
|
| Rate for Payer: Mclaren Commercial |
$1,018.80
|
| 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 |
$962.20
|
| 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 |
$792.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.12
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$803.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$996.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
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 |
$814.14 |
| Rate for Payer: Aetna Commercial |
$437.63
|
| Rate for Payer: Aetna Medicare |
$326.59
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS MAPPO |
$326.59
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$326.59
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$437.63
|
| Rate for Payer: Cofinity Commercial |
$470.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.59
|
| Rate for Payer: Healthscope Commercial |
$391.91
|
| Rate for Payer: Healthscope Whirlpool |
$391.91
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$342.92
|
| Rate for Payer: PACE SWMI |
$326.59
|
| Rate for Payer: PHP Medicare Advantage |
$326.59
|
| 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 Medicare |
$326.59
|
| Rate for Payer: Priority Health Narrow Network |
$513.72
|
| Rate for Payer: UHC Medicare Advantage |
$336.39
|
|
|
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 |
$747.60 |
| Max. Negotiated Rate |
$1,068.00 |
| Rate for Payer: Aetna Commercial |
$961.20
|
| Rate for Payer: ASR ASR |
$1,035.96
|
| Rate for Payer: BCBS Trust/PPO |
$828.02
|
| Rate for Payer: BCN Commercial |
$828.02
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$1,003.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.40
|
| Rate for Payer: Healthscope Commercial |
$1,068.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,035.96
|
| Rate for Payer: Mclaren Commercial |
$961.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$907.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$939.84
|
|
|
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 |
$814.14 |
| Rate for Payer: Aetna Commercial |
$437.63
|
| Rate for Payer: Aetna Medicare |
$326.59
|
| Rate for Payer: BCBS Complete |
$228.12
|
| Rate for Payer: BCBS MAPPO |
$326.59
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$814.14
|
| Rate for Payer: BCN Medicare Advantage |
$326.59
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cash Price |
$854.40
|
| Rate for Payer: Cofinity Commercial |
$470.29
|
| Rate for Payer: Cofinity Commercial |
$437.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.59
|
| Rate for Payer: Healthscope Commercial |
$391.91
|
| Rate for Payer: Healthscope Whirlpool |
$391.91
|
| Rate for Payer: Meridian Medicaid |
$228.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$342.92
|
| Rate for Payer: PACE SWMI |
$326.59
|
| Rate for Payer: PHP Medicare Advantage |
$326.59
|
| 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 Medicare |
$326.59
|
| Rate for Payer: Priority Health Narrow Network |
$513.72
|
| Rate for Payer: UHC Medicare Advantage |
$336.39
|
|
