|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,856.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$313.11 |
| Max. Negotiated Rate |
$1,392.00 |
| Rate for Payer: Aetna Commercial |
$638.85
|
| Rate for Payer: Aetna Medicare |
$476.75
|
| Rate for Payer: BCBS Complete |
$328.77
|
| Rate for Payer: BCBS MAPPO |
$476.75
|
| Rate for Payer: BCN Commercial |
$797.27
|
| Rate for Payer: BCN Medicare Advantage |
$476.75
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cash Price |
$1,484.80
|
| Rate for Payer: Cofinity Commercial |
$686.52
|
| Rate for Payer: Cofinity Commercial |
$638.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.75
|
| Rate for Payer: Healthscope Commercial |
$572.10
|
| Rate for Payer: Healthscope Whirlpool |
$572.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$500.59
|
| Rate for Payer: Meridian Medicaid |
$328.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$524.42
|
| Rate for Payer: Nomi Health Commercial |
$572.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,392.00
|
| Rate for Payer: PACE SWMI |
$476.75
|
| Rate for Payer: PHP Medicare Advantage |
$476.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$852.26
|
| Rate for Payer: Priority Health Medicare |
$476.75
|
| Rate for Payer: Priority Health Narrow Network |
$852.26
|
| Rate for Payer: Railroad Medicare Medicare |
$476.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$476.75
|
| Rate for Payer: UHC Exchange |
$899.27
|
| Rate for Payer: UHC Medicaid |
$313.11
|
| Rate for Payer: UHCCP DNSP |
$476.75
|
| Rate for Payer: UHCCP Medicaid |
$313.11
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$313.32 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$644.50
|
| Rate for Payer: Aetna Medicare |
$480.97
|
| Rate for Payer: BCBS Complete |
$328.99
|
| Rate for Payer: BCBS MAPPO |
$480.97
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: BCN Medicare Advantage |
$480.97
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$692.60
|
| Rate for Payer: Cofinity Commercial |
$644.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.97
|
| Rate for Payer: Healthscope Commercial |
$577.16
|
| Rate for Payer: Healthscope Whirlpool |
$577.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.02
|
| Rate for Payer: Meridian Medicaid |
$328.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$529.07
|
| Rate for Payer: Nomi Health Commercial |
$577.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$480.97
|
| Rate for Payer: PHP Medicare Advantage |
$480.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$858.65
|
| Rate for Payer: Priority Health Medicare |
$480.97
|
| Rate for Payer: Priority Health Narrow Network |
$858.65
|
| Rate for Payer: Railroad Medicare Medicare |
$480.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$922.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.97
|
| Rate for Payer: UHC Exchange |
$922.90
|
| Rate for Payer: UHC Medicaid |
$313.32
|
| Rate for Payer: UHCCP DNSP |
$480.97
|
| Rate for Payer: UHCCP Medicaid |
$313.32
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,786.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,339.50 |
| Max. Negotiated Rate |
$1,786.00 |
| Rate for Payer: Aetna Commercial |
$1,607.40
|
| Rate for Payer: ASR ASR |
$1,732.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.66
|
| Rate for Payer: BCN Commercial |
$1,466.66
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,678.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,428.80
|
| Rate for Payer: Healthscope Commercial |
$1,732.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,786.00
|
| Rate for Payer: Mclaren Commercial |
$1,607.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,518.10
|
| Rate for Payer: Nomi Health Commercial |
$1,464.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,786.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$313.32 |
| Max. Negotiated Rate |
$1,339.50 |
| Rate for Payer: Aetna Commercial |
$644.50
|
| Rate for Payer: Aetna Medicare |
$480.97
|
| Rate for Payer: BCBS Complete |
$328.99
|
| Rate for Payer: BCBS MAPPO |
$480.97
|
| Rate for Payer: BCN Commercial |
$803.24
|
| Rate for Payer: BCN Medicare Advantage |
$480.97
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$692.60
|
| Rate for Payer: Cofinity Commercial |
$644.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.97
|
| Rate for Payer: Healthscope Commercial |
$577.16
|
| Rate for Payer: Healthscope Whirlpool |
$577.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.02
|
| Rate for Payer: Meridian Medicaid |
$328.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$529.07
|
| Rate for Payer: Nomi Health Commercial |
$577.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE SWMI |
$480.97
|
| Rate for Payer: PHP Medicare Advantage |
$480.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$858.65
|
| Rate for Payer: Priority Health Medicare |
$480.97
|
| Rate for Payer: Priority Health Narrow Network |
$858.65
|
| Rate for Payer: Railroad Medicare Medicare |
$480.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$922.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.97
|
| Rate for Payer: UHC Exchange |
$922.90
|
| Rate for Payer: UHC Medicaid |
$313.32
|
| Rate for Payer: UHCCP DNSP |
$480.97
|
| Rate for Payer: UHCCP Medicaid |
$313.32
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,786.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,251.99 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,607.40
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$1,732.42
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,472.56
|
| Rate for Payer: BCN Commercial |
$1,472.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cash Price |
$1,428.80
|
| Rate for Payer: Cofinity Commercial |
$1,678.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,428.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,732.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,786.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,607.40
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,518.10
|
| Rate for Payer: Nomi Health Commercial |
$1,464.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,339.50
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,564.89
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,251.99
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$945.85 |
| Rate for Payer: Aetna Commercial |
$684.20
|
| Rate for Payer: Aetna Medicare |
$510.60
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS MAPPO |
$510.60
|
| Rate for Payer: BCN Commercial |
$832.63
|
| Rate for Payer: BCN Medicare Advantage |
$510.60
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$735.26
|
| Rate for Payer: Cofinity Commercial |
$684.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.60
|
| Rate for Payer: Healthscope Commercial |
$612.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.13
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$561.66
|
| Rate for Payer: Nomi Health Commercial |
$612.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: PACE SWMI |
$510.60
|
| Rate for Payer: PHP Medicare Advantage |
$510.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$890.05
|
| Rate for Payer: Priority Health Medicare |
$510.60
|
| Rate for Payer: Priority Health Narrow Network |
$890.05
|
| Rate for Payer: Railroad Medicare Medicare |
$510.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$945.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$510.60
|
| Rate for Payer: UHC Exchange |
$945.85
|
| Rate for Payer: UHC Medicaid |
$333.77
|
| Rate for Payer: UHCCP DNSP |
$510.60
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,053.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$738.15 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$947.70
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$1,021.41
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$868.20
|
| Rate for Payer: BCN Commercial |
$868.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$989.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,021.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,053.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$947.70
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$863.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$922.64
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$738.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,053.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$945.85 |
| Rate for Payer: Aetna Commercial |
$684.20
|
| Rate for Payer: Aetna Medicare |
$510.60
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS MAPPO |
$510.60
|
| Rate for Payer: BCN Commercial |
$832.63
|
| Rate for Payer: BCN Medicare Advantage |
$510.60
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$735.26
|
| Rate for Payer: Cofinity Commercial |
$684.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.60
|
| Rate for Payer: Healthscope Commercial |
$612.72
|
| Rate for Payer: Healthscope Whirlpool |
$612.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.13
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$561.66
|
| Rate for Payer: Nomi Health Commercial |
$612.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
| Rate for Payer: PACE SWMI |
$510.60
|
| Rate for Payer: PHP Medicare Advantage |
$510.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$890.05
|
| Rate for Payer: Priority Health Medicare |
$510.60
|
| Rate for Payer: Priority Health Narrow Network |
$890.05
|
| Rate for Payer: Railroad Medicare Medicare |
$510.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$945.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$510.60
|
| Rate for Payer: UHC Exchange |
$945.85
|
| Rate for Payer: UHC Medicaid |
$333.77
|
| Rate for Payer: UHCCP DNSP |
$510.60
|
| Rate for Payer: UHCCP Medicaid |
$333.77
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,053.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$789.75 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna Commercial |
$947.70
|
| Rate for Payer: ASR ASR |
$1,021.41
|
| Rate for Payer: BCBS Trust/PPO |
$864.72
|
| Rate for Payer: BCN Commercial |
$864.72
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cofinity Commercial |
$989.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.40
|
| Rate for Payer: Healthscope Commercial |
$1,021.41
|
| Rate for Payer: Healthscope Whirlpool |
$1,053.00
|
| Rate for Payer: Mclaren Commercial |
$947.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.05
|
| Rate for Payer: Nomi Health Commercial |
$863.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.75
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,196.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$1,196.00 |
| Rate for Payer: Aetna Commercial |
$1,076.40
|
| Rate for Payer: ASR ASR |
$1,160.12
|
| Rate for Payer: BCBS Trust/PPO |
$982.16
|
| Rate for Payer: BCN Commercial |
$982.16
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$1,124.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.80
|
| Rate for Payer: Healthscope Commercial |
$1,160.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.00
|
| Rate for Payer: Mclaren Commercial |
$1,076.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.60
|
| Rate for Payer: Nomi Health Commercial |
$980.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,196.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$838.40 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,076.40
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$1,160.12
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$986.10
|
| Rate for Payer: BCN Commercial |
$986.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$1,124.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,160.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,076.40
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.60
|
| Rate for Payer: Nomi Health Commercial |
$980.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,047.94
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$838.40
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,196.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$349.11 |
| Max. Negotiated Rate |
$990.79 |
| Rate for Payer: Aetna Commercial |
$720.46
|
| Rate for Payer: Aetna Medicare |
$537.66
|
| Rate for Payer: BCBS Complete |
$366.57
|
| Rate for Payer: BCBS MAPPO |
$537.66
|
| Rate for Payer: BCN Commercial |
$861.51
|
| Rate for Payer: BCN Medicare Advantage |
$537.66
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$774.23
|
| Rate for Payer: Cofinity Commercial |
$720.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.66
|
| Rate for Payer: Healthscope Commercial |
$645.19
|
| Rate for Payer: Healthscope Whirlpool |
$645.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.54
|
| Rate for Payer: Meridian Medicaid |
$366.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.43
|
| Rate for Payer: Nomi Health Commercial |
$645.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: PACE SWMI |
$537.66
|
| Rate for Payer: PHP Medicare Advantage |
$537.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$920.92
|
| Rate for Payer: Priority Health Medicare |
$537.66
|
| Rate for Payer: Priority Health Narrow Network |
$920.92
|
| Rate for Payer: Railroad Medicare Medicare |
$537.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$990.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.66
|
| Rate for Payer: UHC Exchange |
$990.79
|
| Rate for Payer: UHC Medicaid |
$349.11
|
| Rate for Payer: UHCCP DNSP |
$537.66
|
| Rate for Payer: UHCCP Medicaid |
$349.11
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,196.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$349.11 |
| Max. Negotiated Rate |
$990.79 |
| Rate for Payer: Aetna Commercial |
$720.46
|
| Rate for Payer: Aetna Medicare |
$537.66
|
| Rate for Payer: BCBS Complete |
$366.57
|
| Rate for Payer: BCBS MAPPO |
$537.66
|
| Rate for Payer: BCN Commercial |
$861.51
|
| Rate for Payer: BCN Medicare Advantage |
$537.66
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cash Price |
$956.80
|
| Rate for Payer: Cofinity Commercial |
$774.23
|
| Rate for Payer: Cofinity Commercial |
$720.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.66
|
| Rate for Payer: Healthscope Commercial |
$645.19
|
| Rate for Payer: Healthscope Whirlpool |
$645.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.54
|
| Rate for Payer: Meridian Medicaid |
$366.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.43
|
| Rate for Payer: Nomi Health Commercial |
$645.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$897.00
|
| Rate for Payer: PACE SWMI |
$537.66
|
| Rate for Payer: PHP Medicare Advantage |
$537.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$920.92
|
| Rate for Payer: Priority Health Medicare |
$537.66
|
| Rate for Payer: Priority Health Narrow Network |
$920.92
|
| Rate for Payer: Railroad Medicare Medicare |
$537.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$990.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.66
|
| Rate for Payer: UHC Exchange |
$990.79
|
| Rate for Payer: UHC Medicaid |
$349.11
|
| Rate for Payer: UHCCP DNSP |
$537.66
|
| Rate for Payer: UHCCP Medicaid |
$349.11
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,178.07 |
| Rate for Payer: Aetna Commercial |
$847.26
|
| Rate for Payer: Aetna Medicare |
$632.28
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$632.28
|
| Rate for Payer: BCN Commercial |
$1,011.40
|
| Rate for Payer: BCN Medicare Advantage |
$632.28
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$910.48
|
| Rate for Payer: Cofinity Commercial |
$847.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.28
|
| Rate for Payer: Healthscope Commercial |
$758.74
|
| Rate for Payer: Healthscope Whirlpool |
$758.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.89
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$695.51
|
| Rate for Payer: Nomi Health Commercial |
$758.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PACE SWMI |
$632.28
|
| Rate for Payer: PHP Medicare Advantage |
$632.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,081.16
|
| Rate for Payer: Priority Health Medicare |
$632.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.16
|
| Rate for Payer: Railroad Medicare Medicare |
$632.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,178.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$632.28
|
| Rate for Payer: UHC Exchange |
$1,178.07
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP DNSP |
$632.28
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Facility
|
IP
|
$1,239.00
|
|
|
Service Code
|
CPT 22901
|
| Hospital Charge Code |
22901
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$929.25 |
| Max. Negotiated Rate |
$1,239.00 |
| Rate for Payer: Aetna Commercial |
$1,115.10
|
| Rate for Payer: ASR ASR |
$1,201.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,017.47
|
| Rate for Payer: BCN Commercial |
$1,017.47
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$1,164.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.20
|
| Rate for Payer: Healthscope Commercial |
$1,201.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.00
|
| Rate for Payer: Mclaren Commercial |
$1,115.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.15
|
| Rate for Payer: Nomi Health Commercial |
$1,015.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,239.00
|
|
|
Service Code
|
HCPCS 22901
|
| Hospital Charge Code |
22901
|
| Min. Negotiated Rate |
$409.17 |
| Max. Negotiated Rate |
$1,178.07 |
| Rate for Payer: Aetna Commercial |
$847.26
|
| Rate for Payer: Aetna Medicare |
$632.28
|
| Rate for Payer: BCBS Complete |
$429.63
|
| Rate for Payer: BCBS MAPPO |
$632.28
|
| Rate for Payer: BCN Commercial |
$1,011.40
|
| Rate for Payer: BCN Medicare Advantage |
$632.28
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$910.48
|
| Rate for Payer: Cofinity Commercial |
$847.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.28
|
| Rate for Payer: Healthscope Commercial |
$758.74
|
| Rate for Payer: Healthscope Whirlpool |
$758.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$663.89
|
| Rate for Payer: Meridian Medicaid |
$429.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$695.51
|
| Rate for Payer: Nomi Health Commercial |
$758.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PACE SWMI |
$632.28
|
| Rate for Payer: PHP Medicare Advantage |
$632.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,081.16
|
| Rate for Payer: Priority Health Medicare |
$632.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.16
|
| Rate for Payer: Railroad Medicare Medicare |
$632.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,178.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$632.28
|
| Rate for Payer: UHC Exchange |
$1,178.07
|
| Rate for Payer: UHC Medicaid |
$409.17
|
| Rate for Payer: UHCCP DNSP |
$632.28
|
| Rate for Payer: UHCCP Medicaid |
$409.17
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Facility
|
OP
|
$1,239.00
|
|
|
Service Code
|
CPT 22901
|
| Hospital Charge Code |
22901
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$868.54 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,115.10
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$1,201.83
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.56
|
| Rate for Payer: BCN Commercial |
$1,021.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cash Price |
$991.20
|
| Rate for Payer: Cofinity Commercial |
$1,164.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,201.83
|
| Rate for Payer: Healthscope Whirlpool |
$1,239.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,115.10
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.15
|
| Rate for Payer: Nomi Health Commercial |
$1,015.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,085.61
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$868.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$772.73 |
| Rate for Payer: Aetna Commercial |
$564.02
|
| Rate for Payer: Aetna Medicare |
$420.91
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS MAPPO |
$420.91
|
| Rate for Payer: BCN Commercial |
$670.28
|
| Rate for Payer: BCN Medicare Advantage |
$420.91
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$606.11
|
| Rate for Payer: Cofinity Commercial |
$564.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.91
|
| Rate for Payer: Healthscope Commercial |
$505.09
|
| Rate for Payer: Healthscope Whirlpool |
$505.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.96
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.00
|
| Rate for Payer: Nomi Health Commercial |
$505.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$420.91
|
| Rate for Payer: PHP Medicare Advantage |
$420.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$716.51
|
| Rate for Payer: Priority Health Medicare |
$420.91
|
| Rate for Payer: Priority Health Narrow Network |
$716.51
|
| Rate for Payer: Railroad Medicare Medicare |
$420.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$772.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.91
|
| Rate for Payer: UHC Exchange |
$772.73
|
| Rate for Payer: UHC Medicaid |
$273.49
|
| Rate for Payer: UHCCP DNSP |
$420.91
|
| Rate for Payer: UHCCP Medicaid |
$273.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$735.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$551.25 |
| Max. Negotiated Rate |
$735.00 |
| Rate for Payer: Aetna Commercial |
$661.50
|
| Rate for Payer: ASR ASR |
$712.95
|
| Rate for Payer: BCBS Trust/PPO |
$603.58
|
| Rate for Payer: BCN Commercial |
$603.58
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$690.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.00
|
| Rate for Payer: Healthscope Commercial |
$712.95
|
| Rate for Payer: Healthscope Whirlpool |
$735.00
|
| Rate for Payer: Mclaren Commercial |
$661.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.75
|
| Rate for Payer: Nomi Health Commercial |
$602.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$735.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$515.24 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$661.50
|
| Rate for Payer: Aetna Medicare |
$2,894.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: ASR ASR |
$712.95
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$606.01
|
| Rate for Payer: BCN Commercial |
$606.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$690.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$712.95
|
| Rate for Payer: Healthscope Whirlpool |
$735.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$661.50
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$1,589.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.75
|
| Rate for Payer: Nomi Health Commercial |
$602.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,183.70
|
| Rate for Payer: PHP Medicaid |
$1,551.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$644.01
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$515.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP DNSP |
$2,894.27
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$772.73 |
| Rate for Payer: Aetna Commercial |
$564.02
|
| Rate for Payer: Aetna Medicare |
$420.91
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS MAPPO |
$420.91
|
| Rate for Payer: BCN Commercial |
$670.28
|
| Rate for Payer: BCN Medicare Advantage |
$420.91
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$606.11
|
| Rate for Payer: Cofinity Commercial |
$564.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.91
|
| Rate for Payer: Healthscope Commercial |
$505.09
|
| Rate for Payer: Healthscope Whirlpool |
$505.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.96
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.00
|
| Rate for Payer: Nomi Health Commercial |
$505.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$551.25
|
| Rate for Payer: PACE SWMI |
$420.91
|
| Rate for Payer: PHP Medicare Advantage |
$420.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$716.51
|
| Rate for Payer: Priority Health Medicare |
$420.91
|
| Rate for Payer: Priority Health Narrow Network |
$716.51
|
| Rate for Payer: Railroad Medicare Medicare |
$420.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$772.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$420.91
|
| Rate for Payer: UHC Exchange |
$772.73
|
| Rate for Payer: UHC Medicaid |
$273.49
|
| Rate for Payer: UHCCP DNSP |
$420.91
|
| Rate for Payer: UHCCP Medicaid |
$273.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$211.30 |
| Max. Negotiated Rate |
$611.25 |
| Rate for Payer: Aetna Commercial |
$432.49
|
| Rate for Payer: Aetna Medicare |
$322.75
|
| Rate for Payer: BCBS Complete |
$221.87
|
| Rate for Payer: BCBS MAPPO |
$322.75
|
| Rate for Payer: BCN Commercial |
$509.93
|
| Rate for Payer: BCN Medicare Advantage |
$322.75
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cofinity Commercial |
$464.76
|
| Rate for Payer: Cofinity Commercial |
$432.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.75
|
| Rate for Payer: Healthscope Commercial |
$387.30
|
| Rate for Payer: Healthscope Whirlpool |
$387.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.89
|
| Rate for Payer: Meridian Medicaid |
$221.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.02
|
| Rate for Payer: Nomi Health Commercial |
$387.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$611.25
|
| Rate for Payer: PACE SWMI |
$322.75
|
| Rate for Payer: PHP Medicare Advantage |
$322.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$545.11
|
| Rate for Payer: Priority Health Medicare |
$322.75
|
| Rate for Payer: Priority Health Narrow Network |
$545.11
|
| Rate for Payer: Railroad Medicare Medicare |
$322.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$578.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$322.75
|
| Rate for Payer: UHC Exchange |
$578.79
|
| Rate for Payer: UHC Medicaid |
$211.30
|
| Rate for Payer: UHCCP DNSP |
$322.75
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,242.00
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$931.50 |
| Rate for Payer: Aetna Commercial |
$550.38
|
| Rate for Payer: Aetna Medicare |
$410.73
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$410.73
|
| Rate for Payer: BCN Commercial |
$682.23
|
| Rate for Payer: BCN Medicare Advantage |
$410.73
|
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cofinity Commercial |
$591.45
|
| Rate for Payer: Cofinity Commercial |
$550.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.73
|
| Rate for Payer: Healthscope Commercial |
$492.88
|
| Rate for Payer: Healthscope Whirlpool |
$492.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.27
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$451.80
|
| Rate for Payer: Nomi Health Commercial |
$492.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$931.50
|
| Rate for Payer: PACE SWMI |
$410.73
|
| Rate for Payer: PHP Medicare Advantage |
$410.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$729.29
|
| Rate for Payer: Priority Health Medicare |
$410.73
|
| Rate for Payer: Priority Health Narrow Network |
$729.29
|
| Rate for Payer: Railroad Medicare Medicare |
$410.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$793.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$410.73
|
| Rate for Payer: UHC Exchange |
$793.30
|
| Rate for Payer: UHC Medicaid |
$268.59
|
| Rate for Payer: UHCCP DNSP |
$410.73
|
| Rate for Payer: UHCCP Medicaid |
$268.59
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$907.00
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$210.02 |
| Max. Negotiated Rate |
$680.25 |
| Rate for Payer: Aetna Commercial |
$428.81
|
| Rate for Payer: Aetna Medicare |
$320.01
|
| Rate for Payer: BCBS Complete |
$220.52
|
| Rate for Payer: BCBS MAPPO |
$320.01
|
| Rate for Payer: BCN Commercial |
$530.35
|
| Rate for Payer: BCN Medicare Advantage |
$320.01
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cash Price |
$725.60
|
| Rate for Payer: Cofinity Commercial |
$460.81
|
| Rate for Payer: Cofinity Commercial |
$428.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.01
|
| Rate for Payer: Healthscope Commercial |
$384.01
|
| Rate for Payer: Healthscope Whirlpool |
$384.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.01
|
| Rate for Payer: Meridian Medicaid |
$220.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.01
|
| Rate for Payer: Nomi Health Commercial |
$384.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$680.25
|
| Rate for Payer: PACE SWMI |
$320.01
|
| Rate for Payer: PHP Medicare Advantage |
$320.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$566.93
|
| Rate for Payer: Priority Health Medicare |
$320.01
|
| Rate for Payer: Priority Health Narrow Network |
$566.93
|
| Rate for Payer: Railroad Medicare Medicare |
$320.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$320.01
|
| Rate for Payer: UHC Exchange |
$604.63
|
| Rate for Payer: UHC Medicaid |
$210.02
|
| Rate for Payer: UHCCP DNSP |
$320.01
|
| Rate for Payer: UHCCP Medicaid |
$210.02
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
IP
|
$1,210.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,210.00 |
| Rate for Payer: Aetna Commercial |
$1,089.00
|
| Rate for Payer: ASR ASR |
$1,173.70
|
| Rate for Payer: BCBS Trust/PPO |
$993.65
|
| Rate for Payer: BCN Commercial |
$993.65
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$1,137.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.00
|
| Rate for Payer: Healthscope Commercial |
$1,173.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,210.00
|
| Rate for Payer: Mclaren Commercial |
$1,089.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.50
|
| Rate for Payer: Nomi Health Commercial |
$992.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,064.80
|
|
