|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 25075
|
| Hospital Charge Code |
25075
|
| Min. Negotiated Rate |
$195.53 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Aetna Commercial |
$397.98
|
| Rate for Payer: Aetna Medicare |
$297.00
|
| Rate for Payer: BCBS Complete |
$205.31
|
| Rate for Payer: BCBS MAPPO |
$297.00
|
| Rate for Payer: BCN Commercial |
$485.54
|
| Rate for Payer: BCN Medicare Advantage |
$297.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$427.68
|
| Rate for Payer: Cofinity Commercial |
$397.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.00
|
| Rate for Payer: Healthscope Commercial |
$356.40
|
| Rate for Payer: Healthscope Whirlpool |
$356.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.85
|
| Rate for Payer: Meridian Medicaid |
$205.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.70
|
| Rate for Payer: Nomi Health Commercial |
$356.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PACE SWMI |
$297.00
|
| Rate for Payer: PHP Medicare Advantage |
$297.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$519.02
|
| Rate for Payer: Priority Health Medicare |
$297.00
|
| Rate for Payer: Priority Health Narrow Network |
$519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$297.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.00
|
| Rate for Payer: UHC Exchange |
$547.60
|
| Rate for Payer: UHC Medicaid |
$195.53
|
| Rate for Payer: UHCCP DNSP |
$297.00
|
| Rate for Payer: UHCCP Medicaid |
$195.53
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
OP
|
$1,210.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.21 |
| Max. Negotiated Rate |
$2,550.77 |
| Rate for Payer: Aetna Commercial |
$1,089.00
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$1,173.70
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$997.64
|
| Rate for Payer: BCN Commercial |
$997.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$968.00
|
| 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: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,173.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,210.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,089.00
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| 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: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,060.20
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$848.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,064.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$2,550.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,210.00
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$195.53 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Aetna Commercial |
$397.98
|
| Rate for Payer: Aetna Medicare |
$297.00
|
| Rate for Payer: BCBS Complete |
$205.31
|
| Rate for Payer: BCBS MAPPO |
$297.00
|
| Rate for Payer: BCN Commercial |
$485.54
|
| Rate for Payer: BCN Medicare Advantage |
$297.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cash Price |
$968.00
|
| Rate for Payer: Cofinity Commercial |
$427.68
|
| Rate for Payer: Cofinity Commercial |
$397.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.00
|
| Rate for Payer: Healthscope Commercial |
$356.40
|
| Rate for Payer: Healthscope Whirlpool |
$356.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.85
|
| Rate for Payer: Meridian Medicaid |
$205.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.70
|
| Rate for Payer: Nomi Health Commercial |
$356.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.50
|
| Rate for Payer: PACE SWMI |
$297.00
|
| Rate for Payer: PHP Medicare Advantage |
$297.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$519.02
|
| Rate for Payer: Priority Health Medicare |
$297.00
|
| Rate for Payer: Priority Health Narrow Network |
$519.02
|
| Rate for Payer: Railroad Medicare Medicare |
$297.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$547.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$297.00
|
| Rate for Payer: UHC Exchange |
$547.60
|
| Rate for Payer: UHC Medicaid |
$195.53
|
| Rate for Payer: UHCCP DNSP |
$297.00
|
| Rate for Payer: UHCCP Medicaid |
$195.53
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,457.00
|
|
|
Service Code
|
HCPCS 27634
|
| Min. Negotiated Rate |
$397.46 |
| Max. Negotiated Rate |
$1,842.75 |
| Rate for Payer: Aetna Commercial |
$819.54
|
| Rate for Payer: Aetna Medicare |
$611.60
|
| Rate for Payer: BCBS Complete |
$417.33
|
| Rate for Payer: BCBS MAPPO |
$611.60
|
| Rate for Payer: BCN Commercial |
$1,016.38
|
| Rate for Payer: BCN Medicare Advantage |
$611.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,965.60
|
| Rate for Payer: Cofinity Commercial |
$880.70
|
| Rate for Payer: Cofinity Commercial |
$819.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$611.60
|
| Rate for Payer: Healthscope Commercial |
$733.92
|
| Rate for Payer: Healthscope Whirlpool |
$733.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$642.18
|
| Rate for Payer: Meridian Medicaid |
$417.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$672.76
|
| Rate for Payer: Nomi Health Commercial |
$733.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,842.75
|
| Rate for Payer: PACE SWMI |
$611.60
|
| Rate for Payer: PHP Medicare Advantage |
$611.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,086.48
|
| Rate for Payer: Priority Health Medicare |
$611.60
|
| Rate for Payer: Priority Health Narrow Network |
$1,086.48
|
| Rate for Payer: Railroad Medicare Medicare |
$611.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,198.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$611.60
|
| Rate for Payer: UHC Exchange |
$1,198.22
|
| Rate for Payer: UHC Medicaid |
$397.46
|
| Rate for Payer: UHCCP DNSP |
$611.60
|
| Rate for Payer: UHCCP Medicaid |
$397.46
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,284.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$278.18 |
| Max. Negotiated Rate |
$963.00 |
| Rate for Payer: Aetna Commercial |
$570.84
|
| Rate for Payer: Aetna Medicare |
$426.00
|
| Rate for Payer: BCBS Complete |
$292.09
|
| Rate for Payer: BCBS MAPPO |
$426.00
|
| Rate for Payer: BCN Commercial |
$709.63
|
| Rate for Payer: BCN Medicare Advantage |
$426.00
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cash Price |
$1,027.20
|
| Rate for Payer: Cofinity Commercial |
$613.44
|
| Rate for Payer: Cofinity Commercial |
$570.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.00
|
| Rate for Payer: Healthscope Commercial |
$511.20
|
| Rate for Payer: Healthscope Whirlpool |
$511.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.30
|
| Rate for Payer: Meridian Medicaid |
$292.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$468.60
|
| Rate for Payer: Nomi Health Commercial |
$511.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.00
|
| Rate for Payer: PACE SWMI |
$426.00
|
| Rate for Payer: PHP Medicare Advantage |
$426.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$758.57
|
| Rate for Payer: Priority Health Medicare |
$426.00
|
| Rate for Payer: Priority Health Narrow Network |
$758.57
|
| Rate for Payer: Railroad Medicare Medicare |
$426.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$807.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$426.00
|
| Rate for Payer: UHC Exchange |
$807.19
|
| Rate for Payer: UHC Medicaid |
$278.18
|
| Rate for Payer: UHCCP DNSP |
$426.00
|
| Rate for Payer: UHCCP Medicaid |
$278.18
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,117.00
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$190.21 |
| Max. Negotiated Rate |
$837.75 |
| Rate for Payer: Aetna Commercial |
$387.47
|
| Rate for Payer: Aetna Medicare |
$289.16
|
| Rate for Payer: BCBS Complete |
$199.72
|
| Rate for Payer: BCBS MAPPO |
$289.16
|
| Rate for Payer: BCN Commercial |
$467.11
|
| Rate for Payer: BCN Medicare Advantage |
$289.16
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cash Price |
$893.60
|
| Rate for Payer: Cofinity Commercial |
$416.39
|
| Rate for Payer: Cofinity Commercial |
$387.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.16
|
| Rate for Payer: Healthscope Commercial |
$346.99
|
| Rate for Payer: Healthscope Whirlpool |
$346.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.62
|
| Rate for Payer: Meridian Medicaid |
$199.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.08
|
| Rate for Payer: Nomi Health Commercial |
$346.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$837.75
|
| Rate for Payer: PACE SWMI |
$289.16
|
| Rate for Payer: PHP Medicare Advantage |
$289.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$499.32
|
| Rate for Payer: Priority Health Medicare |
$289.16
|
| Rate for Payer: Priority Health Narrow Network |
$499.32
|
| Rate for Payer: Railroad Medicare Medicare |
$289.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$289.16
|
| Rate for Payer: UHC Exchange |
$529.62
|
| Rate for Payer: UHC Medicaid |
$190.21
|
| Rate for Payer: UHCCP DNSP |
$289.16
|
| Rate for Payer: UHCCP Medicaid |
$190.21
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Aetna Commercial |
$387.05
|
| Rate for Payer: Aetna Medicare |
$288.84
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$288.84
|
| Rate for Payer: BCN Commercial |
$469.10
|
| Rate for Payer: BCN Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$415.93
|
| Rate for Payer: Cofinity Commercial |
$387.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.84
|
| Rate for Payer: Healthscope Commercial |
$346.61
|
| Rate for Payer: Healthscope Whirlpool |
$346.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.28
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.72
|
| Rate for Payer: Nomi Health Commercial |
$346.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE SWMI |
$288.84
|
| Rate for Payer: PHP Medicare Advantage |
$288.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$501.45
|
| Rate for Payer: Priority Health Medicare |
$288.84
|
| Rate for Payer: Priority Health Narrow Network |
$501.45
|
| Rate for Payer: Railroad Medicare Medicare |
$288.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$530.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.84
|
| Rate for Payer: UHC Exchange |
$530.37
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP DNSP |
$288.84
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$189.78 |
| Max. Negotiated Rate |
$622.50 |
| Rate for Payer: Aetna Commercial |
$387.05
|
| Rate for Payer: Aetna Medicare |
$288.84
|
| Rate for Payer: BCBS Complete |
$199.27
|
| Rate for Payer: BCBS MAPPO |
$288.84
|
| Rate for Payer: BCN Commercial |
$469.10
|
| Rate for Payer: BCN Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$415.93
|
| Rate for Payer: Cofinity Commercial |
$387.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.84
|
| Rate for Payer: Healthscope Commercial |
$346.61
|
| Rate for Payer: Healthscope Whirlpool |
$346.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.28
|
| Rate for Payer: Meridian Medicaid |
$199.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$317.72
|
| Rate for Payer: Nomi Health Commercial |
$346.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE SWMI |
$288.84
|
| Rate for Payer: PHP Medicare Advantage |
$288.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$501.45
|
| Rate for Payer: Priority Health Medicare |
$288.84
|
| Rate for Payer: Priority Health Narrow Network |
$501.45
|
| Rate for Payer: Railroad Medicare Medicare |
$288.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$530.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$288.84
|
| Rate for Payer: UHC Exchange |
$530.37
|
| Rate for Payer: UHC Medicaid |
$189.78
|
| Rate for Payer: UHCCP DNSP |
$288.84
|
| Rate for Payer: UHCCP Medicaid |
$189.78
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$830.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$622.50 |
| Max. Negotiated Rate |
$830.00 |
| Rate for Payer: Aetna Commercial |
$747.00
|
| Rate for Payer: ASR ASR |
$805.10
|
| Rate for Payer: BCBS Trust/PPO |
$681.60
|
| Rate for Payer: BCN Commercial |
$681.60
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$664.00
|
| Rate for Payer: Healthscope Commercial |
$805.10
|
| Rate for Payer: Healthscope Whirlpool |
$830.00
|
| Rate for Payer: Mclaren Commercial |
$747.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.50
|
| Rate for Payer: Nomi Health Commercial |
$680.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$830.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$622.50 |
| Max. Negotiated Rate |
$3,844.34 |
| Rate for Payer: Aetna Commercial |
$747.00
|
| Rate for Payer: Aetna Medicare |
$1,645.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: ASR ASR |
$805.10
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$684.34
|
| Rate for Payer: BCN Commercial |
$684.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cash Price |
$664.00
|
| Rate for Payer: Cofinity Commercial |
$780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$664.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$805.10
|
| Rate for Payer: Healthscope Whirlpool |
$830.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$747.00
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$903.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.50
|
| Rate for Payer: Nomi Health Commercial |
$680.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.50
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,810.23
|
| Rate for Payer: PHP Medicaid |
$882.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,844.34
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,075.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP DNSP |
$1,645.66
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,208.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$434.09 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna Commercial |
$898.15
|
| Rate for Payer: Aetna Medicare |
$670.26
|
| Rate for Payer: BCBS Complete |
$455.79
|
| Rate for Payer: BCBS MAPPO |
$670.26
|
| Rate for Payer: BCN Commercial |
$1,107.51
|
| Rate for Payer: BCN Medicare Advantage |
$670.26
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$965.17
|
| Rate for Payer: Cofinity Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.26
|
| Rate for Payer: Healthscope Commercial |
$804.31
|
| Rate for Payer: Healthscope Whirlpool |
$804.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.77
|
| Rate for Payer: Meridian Medicaid |
$455.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$737.29
|
| Rate for Payer: Nomi Health Commercial |
$804.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| Rate for Payer: PACE SWMI |
$670.26
|
| Rate for Payer: PHP Medicare Advantage |
$670.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,183.90
|
| Rate for Payer: Priority Health Medicare |
$670.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,183.90
|
| Rate for Payer: Railroad Medicare Medicare |
$670.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,285.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$670.26
|
| Rate for Payer: UHC Exchange |
$1,285.74
|
| Rate for Payer: UHC Medicaid |
$434.09
|
| Rate for Payer: UHCCP DNSP |
$670.26
|
| Rate for Payer: UHCCP Medicaid |
$434.09
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,208.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$434.09 |
| Max. Negotiated Rate |
$1,656.00 |
| Rate for Payer: Aetna Commercial |
$898.15
|
| Rate for Payer: Aetna Medicare |
$670.26
|
| Rate for Payer: BCBS Complete |
$455.79
|
| Rate for Payer: BCBS MAPPO |
$670.26
|
| Rate for Payer: BCN Commercial |
$1,107.51
|
| Rate for Payer: BCN Medicare Advantage |
$670.26
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$965.17
|
| Rate for Payer: Cofinity Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.26
|
| Rate for Payer: Healthscope Commercial |
$804.31
|
| Rate for Payer: Healthscope Whirlpool |
$804.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.77
|
| Rate for Payer: Meridian Medicaid |
$455.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$737.29
|
| Rate for Payer: Nomi Health Commercial |
$804.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| Rate for Payer: PACE SWMI |
$670.26
|
| Rate for Payer: PHP Medicare Advantage |
$670.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,183.90
|
| Rate for Payer: Priority Health Medicare |
$670.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,183.90
|
| Rate for Payer: Railroad Medicare Medicare |
$670.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,285.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$670.26
|
| Rate for Payer: UHC Exchange |
$1,285.74
|
| Rate for Payer: UHC Medicaid |
$434.09
|
| Rate for Payer: UHCCP DNSP |
$670.26
|
| Rate for Payer: UHCCP Medicaid |
$434.09
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
IP
|
$2,208.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,656.00 |
| Max. Negotiated Rate |
$2,208.00 |
| Rate for Payer: Aetna Commercial |
$1,987.20
|
| Rate for Payer: ASR ASR |
$2,141.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.21
|
| Rate for Payer: BCN Commercial |
$1,813.21
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$2,075.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.40
|
| Rate for Payer: Healthscope Commercial |
$2,141.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,208.00
|
| Rate for Payer: Mclaren Commercial |
$1,987.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,876.80
|
| Rate for Payer: Nomi Health Commercial |
$1,810.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
OP
|
$2,208.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,987.20
|
| 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 |
$2,141.76
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,820.50
|
| Rate for Payer: BCN Commercial |
$1,820.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cash Price |
$1,766.40
|
| Rate for Payer: Cofinity Commercial |
$2,075.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,141.76
|
| Rate for Payer: Healthscope Whirlpool |
$2,208.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,987.20
|
| 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 |
$1,876.80
|
| Rate for Payer: Nomi Health Commercial |
$1,810.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,656.00
|
| 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 |
$1,934.65
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,547.81
|
| 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 PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,307.00
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$374.24 |
| Max. Negotiated Rate |
$1,069.63 |
| Rate for Payer: Aetna Commercial |
$771.01
|
| Rate for Payer: Aetna Medicare |
$575.38
|
| Rate for Payer: BCBS Complete |
$392.95
|
| Rate for Payer: BCBS MAPPO |
$575.38
|
| Rate for Payer: BCN Commercial |
$934.71
|
| Rate for Payer: BCN Medicare Advantage |
$575.38
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cash Price |
$1,045.60
|
| Rate for Payer: Cofinity Commercial |
$828.55
|
| Rate for Payer: Cofinity Commercial |
$771.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.38
|
| Rate for Payer: Healthscope Commercial |
$690.46
|
| Rate for Payer: Healthscope Whirlpool |
$690.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.15
|
| Rate for Payer: Meridian Medicaid |
$392.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$632.92
|
| Rate for Payer: Nomi Health Commercial |
$690.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$980.25
|
| Rate for Payer: PACE SWMI |
$575.38
|
| Rate for Payer: PHP Medicare Advantage |
$575.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$999.17
|
| Rate for Payer: Priority Health Medicare |
$575.38
|
| Rate for Payer: Priority Health Narrow Network |
$999.17
|
| Rate for Payer: Railroad Medicare Medicare |
$575.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,069.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$575.38
|
| Rate for Payer: UHC Exchange |
$1,069.63
|
| Rate for Payer: UHC Medicaid |
$374.24
|
| Rate for Payer: UHCCP DNSP |
$575.38
|
| Rate for Payer: UHCCP Medicaid |
$374.24
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$1,441.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$441.12 |
| Max. Negotiated Rate |
$1,299.41 |
| Rate for Payer: Aetna Commercial |
$912.02
|
| Rate for Payer: Aetna Medicare |
$680.61
|
| Rate for Payer: BCBS Complete |
$463.18
|
| Rate for Payer: BCBS MAPPO |
$680.61
|
| Rate for Payer: BCN Commercial |
$1,112.99
|
| Rate for Payer: BCN Medicare Advantage |
$680.61
|
| Rate for Payer: Cash Price |
$1,152.80
|
| Rate for Payer: Cash Price |
$1,152.80
|
| Rate for Payer: Cofinity Commercial |
$980.08
|
| Rate for Payer: Cofinity Commercial |
$912.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.61
|
| Rate for Payer: Healthscope Commercial |
$816.73
|
| Rate for Payer: Healthscope Whirlpool |
$816.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$714.64
|
| Rate for Payer: Meridian Medicaid |
$463.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$748.67
|
| Rate for Payer: Nomi Health Commercial |
$816.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.75
|
| Rate for Payer: PACE SWMI |
$680.61
|
| Rate for Payer: PHP Medicare Advantage |
$680.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,189.75
|
| Rate for Payer: Priority Health Medicare |
$680.61
|
| Rate for Payer: Priority Health Narrow Network |
$1,189.75
|
| Rate for Payer: Railroad Medicare Medicare |
$680.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,299.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$680.61
|
| Rate for Payer: UHC Exchange |
$1,299.41
|
| Rate for Payer: UHC Medicaid |
$441.12
|
| Rate for Payer: UHCCP DNSP |
$680.61
|
| Rate for Payer: UHCCP Medicaid |
$441.12
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$224.29 |
| Max. Negotiated Rate |
$629.43 |
| Rate for Payer: Aetna Commercial |
$459.98
|
| Rate for Payer: Aetna Medicare |
$343.27
|
| Rate for Payer: BCBS Complete |
$235.50
|
| Rate for Payer: BCBS MAPPO |
$343.27
|
| Rate for Payer: BCN Commercial |
$550.77
|
| Rate for Payer: BCN Medicare Advantage |
$343.27
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$494.31
|
| Rate for Payer: Cofinity Commercial |
$459.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.27
|
| Rate for Payer: Healthscope Commercial |
$411.92
|
| Rate for Payer: Healthscope Whirlpool |
$411.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.43
|
| Rate for Payer: Meridian Medicaid |
$235.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.60
|
| Rate for Payer: Nomi Health Commercial |
$411.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.00
|
| Rate for Payer: PACE SWMI |
$343.27
|
| Rate for Payer: PHP Medicare Advantage |
$343.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$588.75
|
| Rate for Payer: Priority Health Medicare |
$343.27
|
| Rate for Payer: Priority Health Narrow Network |
$588.75
|
| Rate for Payer: Railroad Medicare Medicare |
$343.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$629.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$343.27
|
| Rate for Payer: UHC Exchange |
$629.43
|
| Rate for Payer: UHC Medicaid |
$224.29
|
| Rate for Payer: UHCCP DNSP |
$343.27
|
| Rate for Payer: UHCCP Medicaid |
$224.29
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,635.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,226.25 |
| Max. Negotiated Rate |
$1,635.00 |
| Rate for Payer: Aetna Commercial |
$1,471.50
|
| Rate for Payer: ASR ASR |
$1,585.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.66
|
| Rate for Payer: BCN Commercial |
$1,342.66
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$1,536.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.00
|
| Rate for Payer: Healthscope Commercial |
$1,585.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.00
|
| Rate for Payer: Mclaren Commercial |
$1,471.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.75
|
| Rate for Payer: Nomi Health Commercial |
$1,340.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,635.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$420.04 |
| Max. Negotiated Rate |
$1,226.25 |
| Rate for Payer: Aetna Commercial |
$866.24
|
| Rate for Payer: Aetna Medicare |
$646.45
|
| Rate for Payer: BCBS Complete |
$441.04
|
| Rate for Payer: BCBS MAPPO |
$646.45
|
| Rate for Payer: BCN Commercial |
$1,059.21
|
| Rate for Payer: BCN Medicare Advantage |
$646.45
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$930.89
|
| Rate for Payer: Cofinity Commercial |
$866.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.45
|
| Rate for Payer: Healthscope Commercial |
$775.74
|
| Rate for Payer: Healthscope Whirlpool |
$775.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.77
|
| Rate for Payer: Meridian Medicaid |
$441.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$711.10
|
| Rate for Payer: Nomi Health Commercial |
$775.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PACE SWMI |
$646.45
|
| Rate for Payer: PHP Medicare Advantage |
$646.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,132.26
|
| Rate for Payer: Priority Health Medicare |
$646.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,132.26
|
| Rate for Payer: Railroad Medicare Medicare |
$646.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,221.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$646.45
|
| Rate for Payer: UHC Exchange |
$1,221.58
|
| Rate for Payer: UHC Medicaid |
$420.04
|
| Rate for Payer: UHCCP DNSP |
$646.45
|
| Rate for Payer: UHCCP Medicaid |
$420.04
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,635.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$420.04 |
| Max. Negotiated Rate |
$1,226.25 |
| Rate for Payer: Aetna Commercial |
$866.24
|
| Rate for Payer: Aetna Medicare |
$646.45
|
| Rate for Payer: BCBS Complete |
$441.04
|
| Rate for Payer: BCBS MAPPO |
$646.45
|
| Rate for Payer: BCN Commercial |
$1,059.21
|
| Rate for Payer: BCN Medicare Advantage |
$646.45
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$930.89
|
| Rate for Payer: Cofinity Commercial |
$866.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.45
|
| Rate for Payer: Healthscope Commercial |
$775.74
|
| Rate for Payer: Healthscope Whirlpool |
$775.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.77
|
| Rate for Payer: Meridian Medicaid |
$441.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$711.10
|
| Rate for Payer: Nomi Health Commercial |
$775.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| Rate for Payer: PACE SWMI |
$646.45
|
| Rate for Payer: PHP Medicare Advantage |
$646.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$420.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,132.26
|
| Rate for Payer: Priority Health Medicare |
$646.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,132.26
|
| Rate for Payer: Railroad Medicare Medicare |
$646.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,221.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$646.45
|
| Rate for Payer: UHC Exchange |
$1,221.58
|
| Rate for Payer: UHC Medicaid |
$420.04
|
| Rate for Payer: UHCCP DNSP |
$646.45
|
| Rate for Payer: UHCCP Medicaid |
$420.04
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,635.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,146.13 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,471.50
|
| 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 |
$1,585.95
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,348.06
|
| Rate for Payer: BCN Commercial |
$1,348.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cash Price |
$1,308.00
|
| Rate for Payer: Cofinity Commercial |
$1,536.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,308.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,585.95
|
| Rate for Payer: Healthscope Whirlpool |
$1,635.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,471.50
|
| 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 |
$1,389.75
|
| Rate for Payer: Nomi Health Commercial |
$1,340.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,226.25
|
| 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 |
$1,432.59
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.13
|
| 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 THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,374.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$455.61 |
| Max. Negotiated Rate |
$2,530.50 |
| Rate for Payer: Aetna Commercial |
$940.68
|
| Rate for Payer: Aetna Medicare |
$702.00
|
| Rate for Payer: BCBS Complete |
$478.39
|
| Rate for Payer: BCBS MAPPO |
$702.00
|
| Rate for Payer: BCN Commercial |
$1,146.36
|
| Rate for Payer: BCN Medicare Advantage |
$702.00
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cash Price |
$2,699.20
|
| Rate for Payer: Cofinity Commercial |
$940.68
|
| Rate for Payer: Cofinity Commercial |
$1,010.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.00
|
| Rate for Payer: Healthscope Commercial |
$842.40
|
| Rate for Payer: Healthscope Whirlpool |
$842.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$737.10
|
| Rate for Payer: Meridian Medicaid |
$478.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$772.20
|
| Rate for Payer: Nomi Health Commercial |
$842.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,530.50
|
| Rate for Payer: PACE SWMI |
$702.00
|
| Rate for Payer: PHP Medicare Advantage |
$702.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,225.42
|
| Rate for Payer: Priority Health Medicare |
$702.00
|
| Rate for Payer: Priority Health Narrow Network |
$1,225.42
|
| Rate for Payer: Railroad Medicare Medicare |
$702.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,326.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$702.00
|
| Rate for Payer: UHC Exchange |
$1,326.96
|
| Rate for Payer: UHC Medicaid |
$455.61
|
| Rate for Payer: UHCCP DNSP |
$702.00
|
| Rate for Payer: UHCCP Medicaid |
$455.61
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,800.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$376.37 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$774.61
|
| Rate for Payer: Aetna Medicare |
$578.07
|
| Rate for Payer: BCBS Complete |
$395.19
|
| Rate for Payer: BCBS MAPPO |
$578.07
|
| Rate for Payer: BCN Commercial |
$948.65
|
| Rate for Payer: BCN Medicare Advantage |
$578.07
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cofinity Commercial |
$832.42
|
| Rate for Payer: Cofinity Commercial |
$774.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.07
|
| Rate for Payer: Healthscope Commercial |
$693.68
|
| Rate for Payer: Healthscope Whirlpool |
$693.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.97
|
| Rate for Payer: Meridian Medicaid |
$395.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$635.88
|
| Rate for Payer: Nomi Health Commercial |
$693.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.00
|
| Rate for Payer: PACE SWMI |
$578.07
|
| Rate for Payer: PHP Medicare Advantage |
$578.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,014.08
|
| Rate for Payer: Priority Health Medicare |
$578.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,014.08
|
| Rate for Payer: Railroad Medicare Medicare |
$578.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,092.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$578.07
|
| Rate for Payer: UHC Exchange |
$1,092.39
|
| Rate for Payer: UHC Medicaid |
$376.37
|
| Rate for Payer: UHCCP DNSP |
$578.07
|
| Rate for Payer: UHCCP Medicaid |
$376.37
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$513.64
|
| Rate for Payer: Aetna Medicare |
$383.31
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$383.31
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: BCN Medicare Advantage |
$383.31
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$551.97
|
| Rate for Payer: Cofinity Commercial |
$513.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.31
|
| Rate for Payer: Healthscope Commercial |
$459.97
|
| Rate for Payer: Healthscope Whirlpool |
$459.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.48
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$421.64
|
| Rate for Payer: Nomi Health Commercial |
$459.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE SWMI |
$383.31
|
| Rate for Payer: PHP Medicare Advantage |
$383.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$661.69
|
| Rate for Payer: Priority Health Medicare |
$383.31
|
| Rate for Payer: Priority Health Narrow Network |
$661.69
|
| Rate for Payer: Railroad Medicare Medicare |
$383.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$711.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$383.31
|
| Rate for Payer: UHC Exchange |
$711.00
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP DNSP |
$383.31
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$513.64
|
| Rate for Payer: Aetna Medicare |
$383.31
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$383.31
|
| Rate for Payer: BCN Commercial |
$618.99
|
| Rate for Payer: BCN Medicare Advantage |
$383.31
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$551.97
|
| Rate for Payer: Cofinity Commercial |
$513.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.31
|
| Rate for Payer: Healthscope Commercial |
$459.97
|
| Rate for Payer: Healthscope Whirlpool |
$459.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.48
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$421.64
|
| Rate for Payer: Nomi Health Commercial |
$459.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: PACE SWMI |
$383.31
|
| Rate for Payer: PHP Medicare Advantage |
$383.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$661.69
|
| Rate for Payer: Priority Health Medicare |
$383.31
|
| Rate for Payer: Priority Health Narrow Network |
$661.69
|
| Rate for Payer: Railroad Medicare Medicare |
$383.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$711.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$383.31
|
| Rate for Payer: UHC Exchange |
$711.00
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP DNSP |
$383.31
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
