|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,604.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,203.00 |
| Max. Negotiated Rate |
$1,604.00 |
| Rate for Payer: Aetna Commercial |
$1,443.60
|
| Rate for Payer: ASR ASR |
$1,555.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,317.20
|
| Rate for Payer: BCN Commercial |
$1,317.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,507.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Healthscope Commercial |
$1,555.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,604.00
|
| Rate for Payer: Mclaren Commercial |
$1,443.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,363.40
|
| Rate for Payer: Nomi Health Commercial |
$1,315.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,604.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,124.40 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,443.60
|
| 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 |
$1,555.88
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,322.50
|
| Rate for Payer: BCN Commercial |
$1,322.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cofinity Commercial |
$1,507.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,283.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,555.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,604.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,443.60
|
| 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 |
$1,363.40
|
| Rate for Payer: Nomi Health Commercial |
$1,315.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| 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 |
$1,405.42
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.40
|
| 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 TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,336.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$3,014.28 |
| Rate for Payer: Aetna Commercial |
$1,202.40
|
| 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 |
$1,295.92
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.53
|
| Rate for Payer: BCN Commercial |
$1,101.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$1,255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,295.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,336.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,202.40
|
| 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 |
$1,135.60
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| 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 |
$3,014.28
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$2,411.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,175.68
|
| 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 TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$417.07
|
| Rate for Payer: Aetna Medicare |
$311.25
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$311.25
|
| Rate for Payer: BCN Commercial |
$505.45
|
| Rate for Payer: BCN Medicare Advantage |
$311.25
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$448.20
|
| Rate for Payer: Cofinity Commercial |
$417.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.25
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Healthscope Whirlpool |
$373.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.81
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.38
|
| Rate for Payer: Nomi Health Commercial |
$373.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$311.25
|
| Rate for Payer: PHP Medicare Advantage |
$311.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$540.32
|
| Rate for Payer: Priority Health Medicare |
$311.25
|
| Rate for Payer: Priority Health Narrow Network |
$540.32
|
| Rate for Payer: Railroad Medicare Medicare |
$311.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.25
|
| Rate for Payer: UHC Exchange |
$571.35
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP DNSP |
$311.25
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$204.48 |
| Max. Negotiated Rate |
$1,002.00 |
| Rate for Payer: Aetna Commercial |
$417.07
|
| Rate for Payer: Aetna Medicare |
$311.25
|
| Rate for Payer: BCBS Complete |
$214.70
|
| Rate for Payer: BCBS MAPPO |
$311.25
|
| Rate for Payer: BCN Commercial |
$505.45
|
| Rate for Payer: BCN Medicare Advantage |
$311.25
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$448.20
|
| Rate for Payer: Cofinity Commercial |
$417.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.25
|
| Rate for Payer: Healthscope Commercial |
$373.50
|
| Rate for Payer: Healthscope Whirlpool |
$373.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.81
|
| Rate for Payer: Meridian Medicaid |
$214.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.38
|
| Rate for Payer: Nomi Health Commercial |
$373.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: PACE SWMI |
$311.25
|
| Rate for Payer: PHP Medicare Advantage |
$311.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$540.32
|
| Rate for Payer: Priority Health Medicare |
$311.25
|
| Rate for Payer: Priority Health Narrow Network |
$540.32
|
| Rate for Payer: Railroad Medicare Medicare |
$311.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$311.25
|
| Rate for Payer: UHC Exchange |
$571.35
|
| Rate for Payer: UHC Medicaid |
$204.48
|
| Rate for Payer: UHCCP DNSP |
$311.25
|
| Rate for Payer: UHCCP Medicaid |
$204.48
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,336.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,002.00 |
| Max. Negotiated Rate |
$1,336.00 |
| Rate for Payer: Aetna Commercial |
$1,202.40
|
| Rate for Payer: ASR ASR |
$1,295.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,097.12
|
| Rate for Payer: BCN Commercial |
$1,097.12
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$1,255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.80
|
| Rate for Payer: Healthscope Commercial |
$1,295.92
|
| Rate for Payer: Healthscope Whirlpool |
$1,336.00
|
| Rate for Payer: Mclaren Commercial |
$1,202.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,135.60
|
| Rate for Payer: Nomi Health Commercial |
$1,095.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,002.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,175.68
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$416.63 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$859.52
|
| Rate for Payer: Aetna Medicare |
$641.43
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCBS MAPPO |
$641.43
|
| Rate for Payer: BCN Commercial |
$1,054.73
|
| Rate for Payer: BCN Medicare Advantage |
$641.43
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$923.66
|
| Rate for Payer: Cofinity Commercial |
$859.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.43
|
| Rate for Payer: Healthscope Commercial |
$769.72
|
| Rate for Payer: Healthscope Whirlpool |
$769.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.50
|
| Rate for Payer: Meridian Medicaid |
$437.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.57
|
| Rate for Payer: Nomi Health Commercial |
$769.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PACE SWMI |
$641.43
|
| Rate for Payer: PHP Medicare Advantage |
$641.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,127.47
|
| Rate for Payer: Priority Health Medicare |
$641.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$641.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,221.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.43
|
| Rate for Payer: UHC Exchange |
$1,221.53
|
| Rate for Payer: UHC Medicaid |
$416.63
|
| Rate for Payer: UHCCP DNSP |
$641.43
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,744.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,222.54 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,569.60
|
| 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 |
$1,691.68
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,437.93
|
| Rate for Payer: BCN Commercial |
$1,437.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,639.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,395.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,691.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,744.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,569.60
|
| 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 |
$1,482.40
|
| Rate for Payer: Nomi Health Commercial |
$1,430.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| 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 |
$1,528.09
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,222.54
|
| 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 TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,744.00
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$416.63 |
| Max. Negotiated Rate |
$1,308.00 |
| Rate for Payer: Aetna Commercial |
$859.52
|
| Rate for Payer: Aetna Medicare |
$641.43
|
| Rate for Payer: BCBS Complete |
$437.46
|
| Rate for Payer: BCBS MAPPO |
$641.43
|
| Rate for Payer: BCN Commercial |
$1,054.73
|
| Rate for Payer: BCN Medicare Advantage |
$641.43
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$923.66
|
| Rate for Payer: Cofinity Commercial |
$859.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.43
|
| Rate for Payer: Healthscope Commercial |
$769.72
|
| Rate for Payer: Healthscope Whirlpool |
$769.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.50
|
| Rate for Payer: Meridian Medicaid |
$437.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.57
|
| Rate for Payer: Nomi Health Commercial |
$769.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
| Rate for Payer: PACE SWMI |
$641.43
|
| Rate for Payer: PHP Medicare Advantage |
$641.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,127.47
|
| Rate for Payer: Priority Health Medicare |
$641.43
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$641.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,221.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.43
|
| Rate for Payer: UHC Exchange |
$1,221.53
|
| Rate for Payer: UHC Medicaid |
$416.63
|
| Rate for Payer: UHCCP DNSP |
$641.43
|
| Rate for Payer: UHCCP Medicaid |
$416.63
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,744.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,308.00 |
| Max. Negotiated Rate |
$1,744.00 |
| Rate for Payer: Aetna Commercial |
$1,569.60
|
| Rate for Payer: ASR ASR |
$1,691.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,432.17
|
| Rate for Payer: BCN Commercial |
$1,432.17
|
| Rate for Payer: Cash Price |
$1,395.20
|
| Rate for Payer: Cofinity Commercial |
$1,639.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,395.20
|
| Rate for Payer: Healthscope Commercial |
$1,691.68
|
| Rate for Payer: Healthscope Whirlpool |
$1,744.00
|
| Rate for Payer: Mclaren Commercial |
$1,569.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,482.40
|
| Rate for Payer: Nomi Health Commercial |
$1,430.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,308.00
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$1,190.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$834.19 |
| Max. Negotiated Rate |
$3,617.84 |
| Rate for Payer: Aetna Commercial |
$1,071.00
|
| 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 |
$1,154.30
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$981.15
|
| Rate for Payer: BCN Commercial |
$981.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$1,118.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$952.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$1,154.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,190.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Commercial |
$1,071.00
|
| 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 |
$1,011.50
|
| Rate for Payer: Nomi Health Commercial |
$975.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| 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 |
$1,042.68
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Narrow Network |
$834.19
|
| 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 UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$948.98 |
| Rate for Payer: Aetna Commercial |
$680.67
|
| Rate for Payer: Aetna Medicare |
$507.96
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCBS MAPPO |
$507.96
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: BCN Medicare Advantage |
$507.96
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$731.46
|
| Rate for Payer: Cofinity Commercial |
$680.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.96
|
| Rate for Payer: Healthscope Commercial |
$609.55
|
| Rate for Payer: Healthscope Whirlpool |
$609.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.36
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$558.76
|
| Rate for Payer: Nomi Health Commercial |
$609.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$507.96
|
| Rate for Payer: PHP Medicare Advantage |
$507.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$894.31
|
| Rate for Payer: Priority Health Medicare |
$507.96
|
| Rate for Payer: Priority Health Narrow Network |
$894.31
|
| Rate for Payer: Railroad Medicare Medicare |
$507.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$948.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$507.96
|
| Rate for Payer: UHC Exchange |
$948.98
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP DNSP |
$507.96
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$1,190.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
24076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$892.50 |
| Max. Negotiated Rate |
$1,190.00 |
| Rate for Payer: Aetna Commercial |
$1,071.00
|
| Rate for Payer: ASR ASR |
$1,154.30
|
| Rate for Payer: BCBS Trust/PPO |
$977.23
|
| Rate for Payer: BCN Commercial |
$977.23
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$1,118.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$952.00
|
| Rate for Payer: Healthscope Commercial |
$1,154.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,190.00
|
| Rate for Payer: Mclaren Commercial |
$1,071.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.50
|
| Rate for Payer: Nomi Health Commercial |
$975.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$1,190.00
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
24076
|
| Min. Negotiated Rate |
$332.28 |
| Max. Negotiated Rate |
$948.98 |
| Rate for Payer: Aetna Commercial |
$680.67
|
| Rate for Payer: Aetna Medicare |
$507.96
|
| Rate for Payer: BCBS Complete |
$348.89
|
| Rate for Payer: BCBS MAPPO |
$507.96
|
| Rate for Payer: BCN Commercial |
$836.61
|
| Rate for Payer: BCN Medicare Advantage |
$507.96
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cash Price |
$952.00
|
| Rate for Payer: Cofinity Commercial |
$731.46
|
| Rate for Payer: Cofinity Commercial |
$680.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.96
|
| Rate for Payer: Healthscope Commercial |
$609.55
|
| Rate for Payer: Healthscope Whirlpool |
$609.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.36
|
| Rate for Payer: Meridian Medicaid |
$348.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$558.76
|
| Rate for Payer: Nomi Health Commercial |
$609.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.50
|
| Rate for Payer: PACE SWMI |
$507.96
|
| Rate for Payer: PHP Medicare Advantage |
$507.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$894.31
|
| Rate for Payer: Priority Health Medicare |
$507.96
|
| Rate for Payer: Priority Health Narrow Network |
$894.31
|
| Rate for Payer: Railroad Medicare Medicare |
$507.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$948.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$507.96
|
| Rate for Payer: UHC Exchange |
$948.98
|
| Rate for Payer: UHC Medicaid |
$332.28
|
| Rate for Payer: UHCCP DNSP |
$507.96
|
| Rate for Payer: UHCCP Medicaid |
$332.28
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26115
|
| Hospital Charge Code |
26115
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$415.39
|
| Rate for Payer: Aetna Medicare |
$309.99
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$309.99
|
| Rate for Payer: BCN Commercial |
$514.42
|
| Rate for Payer: BCN Medicare Advantage |
$309.99
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$446.39
|
| Rate for Payer: Cofinity Commercial |
$415.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.99
|
| Rate for Payer: Healthscope Commercial |
$371.99
|
| Rate for Payer: Healthscope Whirlpool |
$371.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.49
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.99
|
| Rate for Payer: Nomi Health Commercial |
$371.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE SWMI |
$309.99
|
| Rate for Payer: PHP Medicare Advantage |
$309.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$309.99
|
| Rate for Payer: Priority Health Narrow Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$309.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.99
|
| Rate for Payer: UHC Exchange |
$571.26
|
| Rate for Payer: UHC Medicaid |
$204.91
|
| Rate for Payer: UHCCP DNSP |
$309.99
|
| Rate for Payer: UHCCP Medicaid |
$204.91
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Professional
|
Both
|
$1,122.00
|
|
|
Service Code
|
HCPCS 26115
|
| Min. Negotiated Rate |
$204.91 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna Commercial |
$415.39
|
| Rate for Payer: Aetna Medicare |
$309.99
|
| Rate for Payer: BCBS Complete |
$215.16
|
| Rate for Payer: BCBS MAPPO |
$309.99
|
| Rate for Payer: BCN Commercial |
$514.42
|
| Rate for Payer: BCN Medicare Advantage |
$309.99
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$446.39
|
| Rate for Payer: Cofinity Commercial |
$415.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.99
|
| Rate for Payer: Healthscope Commercial |
$371.99
|
| Rate for Payer: Healthscope Whirlpool |
$371.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.49
|
| Rate for Payer: Meridian Medicaid |
$215.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.99
|
| Rate for Payer: Nomi Health Commercial |
$371.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| Rate for Payer: PACE SWMI |
$309.99
|
| Rate for Payer: PHP Medicare Advantage |
$309.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$549.90
|
| Rate for Payer: Priority Health Medicare |
$309.99
|
| Rate for Payer: Priority Health Narrow Network |
$549.90
|
| Rate for Payer: Railroad Medicare Medicare |
$309.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$571.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$309.99
|
| Rate for Payer: UHC Exchange |
$571.26
|
| Rate for Payer: UHC Medicaid |
$204.91
|
| Rate for Payer: UHCCP DNSP |
$309.99
|
| Rate for Payer: UHCCP Medicaid |
$204.91
|
|
|
PR EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$786.52 |
| Max. Negotiated Rate |
$2,057.07 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| 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 |
$1,088.34
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$925.09
|
| Rate for Payer: BCN Commercial |
$925.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,088.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,122.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,645.66
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| 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 |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
| 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 |
$983.10
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Narrow Network |
$786.52
|
| 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 TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 26115
|
| Hospital Charge Code |
26115
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$841.50 |
| Max. Negotiated Rate |
$1,122.00 |
| Rate for Payer: Aetna Commercial |
$1,009.80
|
| Rate for Payer: ASR ASR |
$1,088.34
|
| Rate for Payer: BCBS Trust/PPO |
$921.39
|
| Rate for Payer: BCN Commercial |
$921.39
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$1,054.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,088.34
|
| Rate for Payer: Healthscope Whirlpool |
$1,122.00
|
| Rate for Payer: Mclaren Commercial |
$1,009.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$841.50
|
|
|
PR EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 26116
|
| Min. Negotiated Rate |
$315.03 |
| Max. Negotiated Rate |
$1,297.50 |
| Rate for Payer: Aetna Commercial |
$642.03
|
| Rate for Payer: Aetna Medicare |
$479.13
|
| Rate for Payer: BCBS Complete |
$330.78
|
| Rate for Payer: BCBS MAPPO |
$479.13
|
| Rate for Payer: BCN Commercial |
$809.22
|
| Rate for Payer: BCN Medicare Advantage |
$479.13
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$689.95
|
| Rate for Payer: Cofinity Commercial |
$642.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.13
|
| Rate for Payer: Healthscope Commercial |
$574.96
|
| Rate for Payer: Healthscope Whirlpool |
$574.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$503.09
|
| Rate for Payer: Meridian Medicaid |
$330.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$527.04
|
| Rate for Payer: Nomi Health Commercial |
$574.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,297.50
|
| Rate for Payer: PACE SWMI |
$479.13
|
| Rate for Payer: PHP Medicare Advantage |
$479.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$865.03
|
| Rate for Payer: Priority Health Medicare |
$479.13
|
| Rate for Payer: Priority Health Narrow Network |
$865.03
|
| Rate for Payer: Railroad Medicare Medicare |
$479.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$911.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$479.13
|
| Rate for Payer: UHC Exchange |
$911.71
|
| Rate for Payer: UHC Medicaid |
$315.03
|
| Rate for Payer: UHCCP DNSP |
$479.13
|
| Rate for Payer: UHCCP Medicaid |
$315.03
|
|
|
PR EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR
|
Professional
|
Both
|
$5,703.00
|
|
|
Service Code
|
HCPCS 51500
|
| Min. Negotiated Rate |
$369.98 |
| Max. Negotiated Rate |
$4,277.25 |
| Rate for Payer: Aetna Commercial |
$764.98
|
| Rate for Payer: Aetna Medicare |
$570.88
|
| Rate for Payer: BCBS Complete |
$388.48
|
| Rate for Payer: BCBS MAPPO |
$570.88
|
| Rate for Payer: BCN Commercial |
$958.11
|
| Rate for Payer: BCN Medicare Advantage |
$570.88
|
| Rate for Payer: Cash Price |
$4,562.40
|
| Rate for Payer: Cash Price |
$4,562.40
|
| Rate for Payer: Cofinity Commercial |
$822.07
|
| Rate for Payer: Cofinity Commercial |
$764.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$570.88
|
| Rate for Payer: Healthscope Commercial |
$685.06
|
| Rate for Payer: Healthscope Whirlpool |
$685.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$599.42
|
| Rate for Payer: Meridian Medicaid |
$388.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$627.97
|
| Rate for Payer: Nomi Health Commercial |
$685.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,277.25
|
| Rate for Payer: PACE SWMI |
$570.88
|
| Rate for Payer: PHP Medicare Advantage |
$570.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,043.70
|
| Rate for Payer: Priority Health Medicare |
$570.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.70
|
| Rate for Payer: Railroad Medicare Medicare |
$570.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,121.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$570.88
|
| Rate for Payer: UHC Exchange |
$1,121.13
|
| Rate for Payer: UHC Medicaid |
$369.98
|
| Rate for Payer: UHCCP DNSP |
$570.88
|
| Rate for Payer: UHCCP Medicaid |
$369.98
|
|
|
PR EXC URETHRAL DIVERTICULUM SPX FEMALE
|
Professional
|
Both
|
$1,183.00
|
|
|
Service Code
|
HCPCS 53230
|
| Min. Negotiated Rate |
$353.37 |
| Max. Negotiated Rate |
$1,072.59 |
| Rate for Payer: Aetna Commercial |
$731.77
|
| Rate for Payer: Aetna Medicare |
$546.10
|
| Rate for Payer: BCBS Complete |
$371.04
|
| Rate for Payer: BCBS MAPPO |
$546.10
|
| Rate for Payer: BCN Commercial |
$916.28
|
| Rate for Payer: BCN Medicare Advantage |
$546.10
|
| Rate for Payer: Cash Price |
$946.40
|
| Rate for Payer: Cash Price |
$946.40
|
| Rate for Payer: Cofinity Commercial |
$786.38
|
| Rate for Payer: Cofinity Commercial |
$731.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.10
|
| Rate for Payer: Healthscope Commercial |
$655.32
|
| Rate for Payer: Healthscope Whirlpool |
$655.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.40
|
| Rate for Payer: Meridian Medicaid |
$371.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.71
|
| Rate for Payer: Nomi Health Commercial |
$655.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$887.25
|
| Rate for Payer: PACE SWMI |
$546.10
|
| Rate for Payer: PHP Medicare Advantage |
$546.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$998.14
|
| Rate for Payer: Priority Health Medicare |
$546.10
|
| Rate for Payer: Priority Health Narrow Network |
$998.14
|
| Rate for Payer: Railroad Medicare Medicare |
$546.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,072.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$546.10
|
| Rate for Payer: UHC Exchange |
$1,072.59
|
| Rate for Payer: UHC Medicaid |
$353.37
|
| Rate for Payer: UHCCP DNSP |
$546.10
|
| Rate for Payer: UHCCP Medicaid |
$353.37
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL
|
Professional
|
Both
|
$2,207.00
|
|
|
Service Code
|
HCPCS 55535
|
| Min. Negotiated Rate |
$253.68 |
| Max. Negotiated Rate |
$1,655.25 |
| Rate for Payer: Aetna Commercial |
$522.77
|
| Rate for Payer: Aetna Medicare |
$390.13
|
| Rate for Payer: BCBS Complete |
$266.36
|
| Rate for Payer: BCBS MAPPO |
$390.13
|
| Rate for Payer: BCN Commercial |
$648.87
|
| Rate for Payer: BCN Medicare Advantage |
$390.13
|
| Rate for Payer: Cash Price |
$1,765.60
|
| Rate for Payer: Cash Price |
$1,765.60
|
| Rate for Payer: Cofinity Commercial |
$561.79
|
| Rate for Payer: Cofinity Commercial |
$522.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.13
|
| Rate for Payer: Healthscope Commercial |
$468.16
|
| Rate for Payer: Healthscope Whirlpool |
$468.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.64
|
| Rate for Payer: Meridian Medicaid |
$266.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$429.14
|
| Rate for Payer: Nomi Health Commercial |
$468.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,655.25
|
| Rate for Payer: PACE SWMI |
$390.13
|
| Rate for Payer: PHP Medicare Advantage |
$390.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$706.82
|
| Rate for Payer: Priority Health Medicare |
$390.13
|
| Rate for Payer: Priority Health Narrow Network |
$706.82
|
| Rate for Payer: Railroad Medicare Medicare |
$390.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$755.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$390.13
|
| Rate for Payer: UHC Exchange |
$755.75
|
| Rate for Payer: UHC Medicaid |
$253.68
|
| Rate for Payer: UHCCP DNSP |
$390.13
|
| Rate for Payer: UHCCP Medicaid |
$253.68
|
|
|
PR EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 55530
|
| Min. Negotiated Rate |
$208.31 |
| Max. Negotiated Rate |
$616.17 |
| Rate for Payer: Aetna Commercial |
$428.55
|
| Rate for Payer: Aetna Medicare |
$319.81
|
| Rate for Payer: BCBS Complete |
$218.73
|
| Rate for Payer: BCBS MAPPO |
$319.81
|
| Rate for Payer: BCN Commercial |
$531.85
|
| Rate for Payer: BCN Medicare Advantage |
$319.81
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Cofinity Commercial |
$428.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.81
|
| Rate for Payer: Healthscope Commercial |
$383.77
|
| Rate for Payer: Healthscope Whirlpool |
$383.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.80
|
| Rate for Payer: Meridian Medicaid |
$218.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$351.79
|
| Rate for Payer: Nomi Health Commercial |
$383.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.25
|
| Rate for Payer: PACE SWMI |
$319.81
|
| Rate for Payer: PHP Medicare Advantage |
$319.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$579.35
|
| Rate for Payer: Priority Health Medicare |
$319.81
|
| Rate for Payer: Priority Health Narrow Network |
$579.35
|
| Rate for Payer: Railroad Medicare Medicare |
$319.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$616.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$319.81
|
| Rate for Payer: UHC Exchange |
$616.17
|
| Rate for Payer: UHC Medicaid |
$208.31
|
| Rate for Payer: UHCCP DNSP |
$319.81
|
| Rate for Payer: UHCCP Medicaid |
$208.31
|
|
|
PR EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR
|
Professional
|
Both
|
$816.00
|
|
|
Service Code
|
HCPCS 55540
|
| Min. Negotiated Rate |
$344.42 |
| Max. Negotiated Rate |
$977.64 |
| Rate for Payer: Aetna Commercial |
$713.15
|
| Rate for Payer: Aetna Medicare |
$532.20
|
| Rate for Payer: BCBS Complete |
$361.64
|
| Rate for Payer: BCBS MAPPO |
$532.20
|
| Rate for Payer: BCN Commercial |
$842.58
|
| Rate for Payer: BCN Medicare Advantage |
$532.20
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cash Price |
$652.80
|
| Rate for Payer: Cofinity Commercial |
$766.37
|
| Rate for Payer: Cofinity Commercial |
$713.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$532.20
|
| Rate for Payer: Healthscope Commercial |
$638.64
|
| Rate for Payer: Healthscope Whirlpool |
$638.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$558.81
|
| Rate for Payer: Meridian Medicaid |
$361.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$585.42
|
| Rate for Payer: Nomi Health Commercial |
$638.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.00
|
| Rate for Payer: PACE SWMI |
$532.20
|
| Rate for Payer: PHP Medicare Advantage |
$532.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$917.84
|
| Rate for Payer: Priority Health Medicare |
$532.20
|
| Rate for Payer: Priority Health Narrow Network |
$917.84
|
| Rate for Payer: Railroad Medicare Medicare |
$532.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$977.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$532.20
|
| Rate for Payer: UHC Exchange |
$977.64
|
| Rate for Payer: UHC Medicaid |
$344.42
|
| Rate for Payer: UHCCP DNSP |
$532.20
|
| Rate for Payer: UHCCP Medicaid |
$344.42
|
|
|
PR EXC XTRPARENCHYMAL LESION TESTIS
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 54512
|
| Min. Negotiated Rate |
$312.68 |
| Max. Negotiated Rate |
$949.71 |
| Rate for Payer: Aetna Commercial |
$646.82
|
| Rate for Payer: Aetna Medicare |
$482.70
|
| Rate for Payer: BCBS Complete |
$328.31
|
| Rate for Payer: BCBS MAPPO |
$482.70
|
| Rate for Payer: BCN Commercial |
$810.21
|
| Rate for Payer: BCN Medicare Advantage |
$482.70
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$695.09
|
| Rate for Payer: Cofinity Commercial |
$646.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.70
|
| Rate for Payer: Healthscope Commercial |
$579.24
|
| Rate for Payer: Healthscope Whirlpool |
$579.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.83
|
| Rate for Payer: Meridian Medicaid |
$328.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$530.97
|
| Rate for Payer: Nomi Health Commercial |
$579.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.75
|
| Rate for Payer: PACE SWMI |
$482.70
|
| Rate for Payer: PHP Medicare Advantage |
$482.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$882.59
|
| Rate for Payer: Priority Health Medicare |
$482.70
|
| Rate for Payer: Priority Health Narrow Network |
$882.59
|
| Rate for Payer: Railroad Medicare Medicare |
$482.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$949.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$482.70
|
| Rate for Payer: UHC Exchange |
$949.71
|
| Rate for Payer: UHC Medicaid |
$312.68
|
| Rate for Payer: UHCCP DNSP |
$482.70
|
| Rate for Payer: UHCCP Medicaid |
$312.68
|
|
