|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$801.45 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,109.70
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$1,196.01
|
| Rate for Payer: ASR Commercial |
$1,196.01
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.70
|
| Rate for Payer: BCN Commercial |
$955.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,159.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.01
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,109.70
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$1,011.06
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.35
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$864.33
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,085.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Min. Negotiated Rate |
$433.92 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$433.92
|
| Rate for Payer: BCBS Complete |
$493.20
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Healthscope Commercial |
$520.70
|
| Rate for Payer: Healthscope Whirlpool |
$520.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP DNSP |
$433.92
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$801.45 |
| Max. Negotiated Rate |
$1,233.00 |
| Rate for Payer: Aetna Commercial |
$1,109.70
|
| Rate for Payer: ASR ASR |
$1,196.01
|
| Rate for Payer: ASR Commercial |
$1,196.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.77
|
| Rate for Payer: BCN Commercial |
$955.94
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$1,159.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.40
|
| Rate for Payer: Healthscope Commercial |
$1,233.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,196.01
|
| Rate for Payer: Mclaren Commercial |
$1,109.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,048.05
|
| Rate for Payer: Nomi Health Commercial |
$1,011.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,085.04
|
|
|
PR EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>
|
Professional
|
Both
|
$1,233.00
|
|
|
Service Code
|
HCPCS 21552
|
| Hospital Charge Code |
21552
|
| Min. Negotiated Rate |
$433.92 |
| Max. Negotiated Rate |
$801.45 |
| Rate for Payer: Aetna Commercial |
$581.45
|
| Rate for Payer: Aetna Medicare |
$433.92
|
| Rate for Payer: BCBS Complete |
$493.20
|
| Rate for Payer: BCBS MAPPO |
$433.92
|
| Rate for Payer: BCN Medicare Advantage |
$433.92
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cash Price |
$986.40
|
| Rate for Payer: Cofinity Commercial |
$624.84
|
| Rate for Payer: Cofinity Commercial |
$581.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.92
|
| Rate for Payer: Healthscope Commercial |
$520.70
|
| Rate for Payer: Healthscope Whirlpool |
$520.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.62
|
| Rate for Payer: Nomi Health Commercial |
$520.70
|
| Rate for Payer: PACE SWMI |
$433.92
|
| Rate for Payer: PHP Medicare Advantage |
$433.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.45
|
| Rate for Payer: Priority Health Medicare |
$433.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.92
|
| Rate for Payer: UHCCP DNSP |
$433.92
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$770.25 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,066.50
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$1,149.45
|
| Rate for Payer: ASR Commercial |
$1,149.45
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$970.40
|
| Rate for Payer: BCN Commercial |
$918.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,185.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.45
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,066.50
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,038.30
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$830.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Hospital Charge Code |
21933
|
| Min. Negotiated Rate |
$474.00 |
| Max. Negotiated Rate |
$1,029.96 |
| Rate for Payer: Aetna Commercial |
$958.43
|
| Rate for Payer: Aetna Medicare |
$715.25
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.43
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Healthscope Commercial |
$858.30
|
| Rate for Payer: Healthscope Whirlpool |
$858.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP DNSP |
$715.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,185.00
|
|
|
Service Code
|
CPT 21933
|
| Hospital Charge Code |
21933
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$770.25 |
| Max. Negotiated Rate |
$1,185.00 |
| Rate for Payer: Aetna Commercial |
$1,066.50
|
| Rate for Payer: ASR ASR |
$1,149.45
|
| Rate for Payer: ASR Commercial |
$1,149.45
|
| Rate for Payer: BCBS Trust/PPO |
$965.66
|
| Rate for Payer: BCN Commercial |
$918.73
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$1,113.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.00
|
| Rate for Payer: Healthscope Commercial |
$1,185.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,149.45
|
| Rate for Payer: Mclaren Commercial |
$1,066.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.25
|
| Rate for Payer: Nomi Health Commercial |
$971.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.80
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,185.00
|
|
|
Service Code
|
HCPCS 21933
|
| Min. Negotiated Rate |
$474.00 |
| Max. Negotiated Rate |
$1,029.96 |
| Rate for Payer: Aetna Commercial |
$958.43
|
| Rate for Payer: Aetna Medicare |
$715.25
|
| Rate for Payer: BCBS Complete |
$474.00
|
| Rate for Payer: BCBS MAPPO |
$715.25
|
| Rate for Payer: BCN Medicare Advantage |
$715.25
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cash Price |
$948.00
|
| Rate for Payer: Cofinity Commercial |
$958.43
|
| Rate for Payer: Cofinity Commercial |
$1,029.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.25
|
| Rate for Payer: Healthscope Commercial |
$858.30
|
| Rate for Payer: Healthscope Whirlpool |
$858.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.01
|
| Rate for Payer: Nomi Health Commercial |
$858.30
|
| Rate for Payer: PACE SWMI |
$715.25
|
| Rate for Payer: PHP Medicare Advantage |
$715.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.25
|
| Rate for Payer: Priority Health Medicare |
$715.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.25
|
| Rate for Payer: UHC Medicare Advantage |
$715.25
|
| Rate for Payer: UHCCP DNSP |
$715.25
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$644.56 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$644.56
|
| Rate for Payer: BCBS Complete |
$806.00
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Healthscope Commercial |
$773.47
|
| Rate for Payer: Healthscope Whirlpool |
$773.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP DNSP |
$644.56
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$644.56 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$863.71
|
| Rate for Payer: Aetna Medicare |
$644.56
|
| Rate for Payer: BCBS Complete |
$806.00
|
| Rate for Payer: BCBS MAPPO |
$644.56
|
| Rate for Payer: BCN Medicare Advantage |
$644.56
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$928.17
|
| Rate for Payer: Cofinity Commercial |
$863.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.56
|
| Rate for Payer: Healthscope Commercial |
$773.47
|
| Rate for Payer: Healthscope Whirlpool |
$773.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.79
|
| Rate for Payer: Nomi Health Commercial |
$773.47
|
| Rate for Payer: PACE SWMI |
$644.56
|
| Rate for Payer: PHP Medicare Advantage |
$644.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health Medicare |
$644.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.56
|
| Rate for Payer: UHC Medicare Advantage |
$644.56
|
| Rate for Payer: UHCCP DNSP |
$644.56
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
IP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,309.75 |
| Max. Negotiated Rate |
$2,015.00 |
| Rate for Payer: Aetna Commercial |
$1,813.50
|
| Rate for Payer: ASR ASR |
$1,954.55
|
| Rate for Payer: ASR Commercial |
$1,954.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,642.02
|
| Rate for Payer: BCN Commercial |
$1,562.23
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,894.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Healthscope Commercial |
$2,015.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,954.55
|
| Rate for Payer: Mclaren Commercial |
$1,813.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.20
|
|
|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Facility
|
OP
|
$2,015.00
|
|
|
Service Code
|
CPT 21932
|
| Hospital Charge Code |
21932
|
| Min. Negotiated Rate |
$1,309.75 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,813.50
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$1,954.55
|
| Rate for Payer: ASR Commercial |
$1,954.55
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.08
|
| Rate for Payer: BCN Commercial |
$1,562.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cofinity Commercial |
$1,894.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,015.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,954.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,813.50
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.75
|
| Rate for Payer: Nomi Health Commercial |
$1,652.30
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,765.54
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,412.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$353.20 |
| Max. Negotiated Rate |
$720.17 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$500.12
|
| Rate for Payer: BCBS Complete |
$353.20
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Healthscope Commercial |
$600.14
|
| Rate for Payer: Healthscope Whirlpool |
$600.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP DNSP |
$500.12
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$573.95 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$794.70
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$856.51
|
| Rate for Payer: ASR Commercial |
$856.51
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$723.09
|
| Rate for Payer: BCN Commercial |
$684.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$830.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$883.00
|
| Rate for Payer: Healthscope Whirlpool |
$856.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$794.70
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: Nomi Health Commercial |
$724.06
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$773.68
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$618.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Facility
|
IP
|
$883.00
|
|
|
Service Code
|
CPT 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$573.95 |
| Max. Negotiated Rate |
$883.00 |
| Rate for Payer: Aetna Commercial |
$794.70
|
| Rate for Payer: ASR ASR |
$856.51
|
| Rate for Payer: ASR Commercial |
$856.51
|
| Rate for Payer: BCBS Trust/PPO |
$719.56
|
| Rate for Payer: BCN Commercial |
$684.59
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$830.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.40
|
| Rate for Payer: Healthscope Commercial |
$883.00
|
| Rate for Payer: Healthscope Whirlpool |
$856.51
|
| Rate for Payer: Mclaren Commercial |
$794.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: Nomi Health Commercial |
$724.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.04
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Hospital Charge Code |
21014
|
| Min. Negotiated Rate |
$353.20 |
| Max. Negotiated Rate |
$720.17 |
| Rate for Payer: Aetna Commercial |
$670.16
|
| Rate for Payer: Aetna Medicare |
$500.12
|
| Rate for Payer: BCBS Complete |
$353.20
|
| Rate for Payer: BCBS MAPPO |
$500.12
|
| Rate for Payer: BCN Medicare Advantage |
$500.12
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cofinity Commercial |
$720.17
|
| Rate for Payer: Cofinity Commercial |
$670.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.12
|
| Rate for Payer: Healthscope Commercial |
$600.14
|
| Rate for Payer: Healthscope Whirlpool |
$600.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.13
|
| Rate for Payer: Nomi Health Commercial |
$600.14
|
| Rate for Payer: PACE SWMI |
$500.12
|
| Rate for Payer: PHP Medicare Advantage |
$500.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health Medicare |
$500.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.12
|
| Rate for Payer: UHC Medicare Advantage |
$500.12
|
| Rate for Payer: UHCCP DNSP |
$500.12
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$373.60 |
| Max. Negotiated Rate |
$607.10 |
| Rate for Payer: Aetna Commercial |
$514.61
|
| Rate for Payer: Aetna Medicare |
$384.04
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS MAPPO |
$384.04
|
| Rate for Payer: BCN Medicare Advantage |
$384.04
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cofinity Commercial |
$553.02
|
| Rate for Payer: Cofinity Commercial |
$514.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.04
|
| Rate for Payer: Healthscope Commercial |
$460.85
|
| Rate for Payer: Healthscope Whirlpool |
$460.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.24
|
| Rate for Payer: Nomi Health Commercial |
$460.85
|
| Rate for Payer: PACE SWMI |
$384.04
|
| Rate for Payer: PHP Medicare Advantage |
$384.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health Medicare |
$384.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.04
|
| Rate for Payer: UHC Medicare Advantage |
$384.04
|
| Rate for Payer: UHCCP DNSP |
$384.04
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$411.45 |
| Max. Negotiated Rate |
$1,047.15 |
| Rate for Payer: Aetna Commercial |
$551.34
|
| Rate for Payer: Aetna Medicare |
$411.45
|
| Rate for Payer: BCBS Complete |
$644.40
|
| Rate for Payer: BCBS MAPPO |
$411.45
|
| Rate for Payer: BCN Medicare Advantage |
$411.45
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cofinity Commercial |
$592.49
|
| Rate for Payer: Cofinity Commercial |
$551.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.45
|
| Rate for Payer: Healthscope Commercial |
$493.74
|
| Rate for Payer: Healthscope Whirlpool |
$493.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$432.02
|
| Rate for Payer: Nomi Health Commercial |
$493.74
|
| Rate for Payer: PACE SWMI |
$411.45
|
| Rate for Payer: PHP Medicare Advantage |
$411.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health Medicare |
$411.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.45
|
| Rate for Payer: UHC Medicare Advantage |
$411.45
|
| Rate for Payer: UHCCP DNSP |
$411.45
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$502.20 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$672.95
|
| Rate for Payer: Aetna Medicare |
$502.20
|
| Rate for Payer: BCBS Complete |
$720.80
|
| Rate for Payer: BCBS MAPPO |
$502.20
|
| Rate for Payer: BCN Medicare Advantage |
$502.20
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cofinity Commercial |
$723.17
|
| Rate for Payer: Cofinity Commercial |
$672.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.20
|
| Rate for Payer: Healthscope Commercial |
$602.64
|
| Rate for Payer: Healthscope Whirlpool |
$602.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.31
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PACE SWMI |
$502.20
|
| Rate for Payer: PHP Medicare Advantage |
$502.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health Medicare |
$502.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.20
|
| Rate for Payer: UHC Medicare Advantage |
$502.20
|
| Rate for Payer: UHCCP DNSP |
$502.20
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,127.10 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,560.60
|
| Rate for Payer: Aetna Medicare |
$2,791.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: ASR ASR |
$1,681.98
|
| Rate for Payer: ASR Commercial |
$1,681.98
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,419.97
|
| Rate for Payer: BCN Commercial |
$1,344.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,629.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,734.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,681.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,560.60
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: Nomi Health Commercial |
$1,421.88
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,070.43
|
| Rate for Payer: PHP Medicaid |
$1,496.14
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,519.33
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,215.53
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,525.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$4,326.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP DNSP |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$509.82
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Healthscope Commercial |
$611.78
|
| Rate for Payer: Healthscope Whirlpool |
$611.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP DNSP |
$509.82
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,734.00
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
21556
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,127.10 |
| Max. Negotiated Rate |
$1,734.00 |
| Rate for Payer: Aetna Commercial |
$1,560.60
|
| Rate for Payer: ASR ASR |
$1,681.98
|
| Rate for Payer: ASR Commercial |
$1,681.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,413.04
|
| Rate for Payer: BCN Commercial |
$1,344.37
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,629.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Healthscope Commercial |
$1,734.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,681.98
|
| Rate for Payer: Mclaren Commercial |
$1,560.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,473.90
|
| Rate for Payer: Nomi Health Commercial |
$1,421.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,525.92
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Hospital Charge Code |
21556
|
| Min. Negotiated Rate |
$509.82 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$683.16
|
| Rate for Payer: Aetna Medicare |
$509.82
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS MAPPO |
$509.82
|
| Rate for Payer: BCN Medicare Advantage |
$509.82
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$734.14
|
| Rate for Payer: Cofinity Commercial |
$683.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.82
|
| Rate for Payer: Healthscope Commercial |
$611.78
|
| Rate for Payer: Healthscope Whirlpool |
$611.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.31
|
| Rate for Payer: Nomi Health Commercial |
$611.78
|
| Rate for Payer: PACE SWMI |
$509.82
|
| Rate for Payer: PHP Medicare Advantage |
$509.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health Medicare |
$509.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.82
|
| Rate for Payer: UHC Medicare Advantage |
$509.82
|
| Rate for Payer: UHCCP DNSP |
$509.82
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$408.80 |
| Max. Negotiated Rate |
$759.86 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$527.68
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Healthscope Commercial |
$633.22
|
| Rate for Payer: Healthscope Whirlpool |
$633.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP DNSP |
$527.68
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$408.80 |
| Max. Negotiated Rate |
$759.86 |
| Rate for Payer: Aetna Commercial |
$707.09
|
| Rate for Payer: Aetna Medicare |
$527.68
|
| Rate for Payer: BCBS Complete |
$408.80
|
| Rate for Payer: BCBS MAPPO |
$527.68
|
| Rate for Payer: BCN Medicare Advantage |
$527.68
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$759.86
|
| Rate for Payer: Cofinity Commercial |
$707.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.68
|
| Rate for Payer: Healthscope Commercial |
$633.22
|
| Rate for Payer: Healthscope Whirlpool |
$633.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.06
|
| Rate for Payer: Nomi Health Commercial |
$633.22
|
| Rate for Payer: PACE SWMI |
$527.68
|
| Rate for Payer: PHP Medicare Advantage |
$527.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health Medicare |
$527.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.68
|
| Rate for Payer: UHC Medicare Advantage |
$527.68
|
| Rate for Payer: UHCCP DNSP |
$527.68
|
|
