|
PR EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,015.00
|
|
|
Service Code
|
HCPCS 21932
|
| Min. Negotiated Rate |
$120.86 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$887.07
|
| Rate for Payer: Aetna Medicare |
$1,007.50
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$803.23
|
| Rate for Payer: UHC Exchange |
$803.23
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,813.50
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$1,954.55
|
| Rate for Payer: ASR Commercial |
$1,954.55
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.08
|
| Rate for Payer: BCN Commercial |
$1,562.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$2,015.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,954.55
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,813.50
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| 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 |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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 |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,412.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,773.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
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 |
$120.86 |
| Max. Negotiated Rate |
$1,309.75 |
| Rate for Payer: Aetna Commercial |
$887.07
|
| Rate for Payer: Aetna Medicare |
$1,007.50
|
| Rate for Payer: BCBS Complete |
$453.34
|
| Rate for Payer: BCBS Trust/PPO |
$120.86
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Cash Price |
$1,612.00
|
| Rate for Payer: Meridian Medicaid |
$453.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$431.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,309.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,019.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,019.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$803.23
|
| Rate for Payer: UHC Exchange |
$803.23
|
| Rate for Payer: UHCCP Medicaid |
$431.75
|
|
|
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 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 |
$338.46 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$692.90
|
| Rate for Payer: Aetna Medicare |
$441.50
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Meridian Medicaid |
$355.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.99
|
| Rate for Payer: Priority Health Narrow Network |
$802.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$615.86
|
| Rate for Payer: UHC Exchange |
$615.86
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
|
|
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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$794.70
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$856.51
|
| Rate for Payer: ASR Commercial |
$856.51
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$723.09
|
| Rate for Payer: BCN Commercial |
$684.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$883.00
|
| Rate for Payer: Healthscope Whirlpool |
$856.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$794.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.55
|
| Rate for Payer: Nomi Health Commercial |
$724.06
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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 |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$618.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$777.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>
|
Professional
|
Both
|
$883.00
|
|
|
Service Code
|
HCPCS 21014
|
| Min. Negotiated Rate |
$338.46 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$692.90
|
| Rate for Payer: Aetna Medicare |
$441.50
|
| Rate for Payer: BCBS Complete |
$355.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$766.73
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Cash Price |
$706.40
|
| Rate for Payer: Meridian Medicaid |
$355.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$802.99
|
| Rate for Payer: Priority Health Narrow Network |
$802.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$615.86
|
| Rate for Payer: UHC Exchange |
$615.86
|
| Rate for Payer: UHCCP Medicaid |
$338.46
|
|
|
PR EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM
|
Professional
|
Both
|
$934.00
|
|
|
Service Code
|
HCPCS 21013
|
| Min. Negotiated Rate |
$260.50 |
| Max. Negotiated Rate |
$1,797.52 |
| Rate for Payer: Aetna Commercial |
$530.82
|
| Rate for Payer: Aetna Medicare |
$467.00
|
| Rate for Payer: BCBS Complete |
$273.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.52
|
| Rate for Payer: BCN Commercial |
$789.70
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Meridian Medicaid |
$273.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$607.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.29
|
| Rate for Payer: Priority Health Narrow Network |
$619.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.20
|
| Rate for Payer: UHC Exchange |
$468.20
|
| Rate for Payer: UHCCP Medicaid |
$260.50
|
|
|
PR EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Professional
|
Both
|
$1,611.00
|
|
|
Service Code
|
HCPCS 25071
|
| Min. Negotiated Rate |
$171.70 |
| Max. Negotiated Rate |
$1,047.15 |
| Rate for Payer: Aetna Commercial |
$565.63
|
| Rate for Payer: Aetna Medicare |
$805.50
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS Trust/PPO |
$171.70
|
| Rate for Payer: BCN Commercial |
$624.04
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,047.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$656.94
|
| Rate for Payer: Priority Health Narrow Network |
$656.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$504.48
|
| Rate for Payer: UHC Exchange |
$504.48
|
| Rate for Payer: UHCCP Medicaid |
$277.33
|
|
|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$1,802.00
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$235.09 |
| Max. Negotiated Rate |
$1,171.30 |
| Rate for Payer: Aetna Commercial |
$687.12
|
| Rate for Payer: Aetna Medicare |
$901.00
|
| Rate for Payer: BCBS Complete |
$358.06
|
| Rate for Payer: BCBS Trust/PPO |
$235.09
|
| Rate for Payer: BCN Commercial |
$767.22
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Cash Price |
$1,441.60
|
| Rate for Payer: Meridian Medicaid |
$358.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$806.03
|
| Rate for Payer: Priority Health Narrow Network |
$806.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.17
|
| Rate for Payer: UHC Exchange |
$587.17
|
| Rate for Payer: UHCCP Medicaid |
$341.01
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,734.00
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$705.78
|
| Rate for Payer: Aetna Medicare |
$867.00
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.21
|
| Rate for Payer: Priority Health Narrow Network |
$816.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.66
|
| Rate for Payer: UHC Exchange |
$587.66
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
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
|
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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,560.60
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$1,681.98
|
| Rate for Payer: ASR Commercial |
$1,681.98
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,419.97
|
| Rate for Payer: BCN Commercial |
$1,344.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,734.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,681.98
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,560.60
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| 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 |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| 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 |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,215.53
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,525.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
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 |
$57.48 |
| Max. Negotiated Rate |
$1,127.10 |
| Rate for Payer: Aetna Commercial |
$705.78
|
| Rate for Payer: Aetna Medicare |
$867.00
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$780.42
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Meridian Medicaid |
$360.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$816.21
|
| Rate for Payer: Priority Health Narrow Network |
$816.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$587.66
|
| Rate for Payer: UHC Exchange |
$587.66
|
| Rate for Payer: UHCCP Medicaid |
$343.57
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$664.30 |
| Max. Negotiated Rate |
$1,022.00 |
| Rate for Payer: Aetna Commercial |
$919.80
|
| Rate for Payer: ASR ASR |
$991.34
|
| Rate for Payer: ASR Commercial |
$991.34
|
| Rate for Payer: BCBS Trust/PPO |
$832.83
|
| Rate for Payer: BCN Commercial |
$792.36
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$960.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Healthscope Commercial |
$1,022.00
|
| Rate for Payer: Healthscope Whirlpool |
$991.34
|
| Rate for Payer: Mclaren Commercial |
$919.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.36
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$840.13 |
| Rate for Payer: Aetna Commercial |
$722.71
|
| Rate for Payer: Aetna Medicare |
$511.00
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.13
|
| Rate for Payer: Priority Health Narrow Network |
$840.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.29
|
| Rate for Payer: UHC Exchange |
$620.29
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$1,022.00
|
|
|
Service Code
|
HCPCS 23076
|
| Hospital Charge Code |
23076
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$840.13 |
| Rate for Payer: Aetna Commercial |
$722.71
|
| Rate for Payer: Aetna Medicare |
$511.00
|
| Rate for Payer: BCBS Complete |
$373.95
|
| Rate for Payer: BCBS Trust/PPO |
$93.51
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Meridian Medicaid |
$373.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$356.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$840.13
|
| Rate for Payer: Priority Health Narrow Network |
$840.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$620.29
|
| Rate for Payer: UHC Exchange |
$620.29
|
| Rate for Payer: UHCCP Medicaid |
$356.14
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$1,022.00
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
23076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$664.30 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$919.80
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$991.34
|
| Rate for Payer: ASR Commercial |
$991.34
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$836.92
|
| Rate for Payer: BCN Commercial |
$792.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cash Price |
$817.60
|
| Rate for Payer: Cofinity Commercial |
$960.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,022.00
|
| Rate for Payer: Healthscope Whirlpool |
$991.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$919.80
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.70
|
| Rate for Payer: Nomi Health Commercial |
$838.04
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$664.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$895.48
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$716.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$899.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$872.70 |
| Rate for Payer: Aetna Commercial |
$757.16
|
| Rate for Payer: Aetna Medicare |
$580.50
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$603.89
|
| Rate for Payer: UHC Exchange |
$603.89
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
IP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$754.65 |
| Max. Negotiated Rate |
$1,161.00 |
| Rate for Payer: Aetna Commercial |
$1,044.90
|
| Rate for Payer: ASR ASR |
$1,126.17
|
| Rate for Payer: ASR Commercial |
$1,126.17
|
| Rate for Payer: BCBS Trust/PPO |
$946.10
|
| Rate for Payer: BCN Commercial |
$900.12
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$1,091.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Healthscope Commercial |
$1,161.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,126.17
|
| Rate for Payer: Mclaren Commercial |
$1,044.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.85
|
| Rate for Payer: Nomi Health Commercial |
$952.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.68
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Facility
|
OP
|
$1,161.00
|
|
|
Service Code
|
CPT 22900
|
| Hospital Charge Code |
22900
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$754.65 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,044.90
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$1,126.17
|
| Rate for Payer: ASR Commercial |
$1,126.17
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$950.74
|
| Rate for Payer: BCN Commercial |
$900.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cofinity Commercial |
$1,091.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,161.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,126.17
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,044.90
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.85
|
| Rate for Payer: Nomi Health Commercial |
$952.02
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,017.27
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$813.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,021.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,161.00
|
|
|
Service Code
|
HCPCS 22900
|
| Hospital Charge Code |
22900
|
| Min. Negotiated Rate |
$232.20 |
| Max. Negotiated Rate |
$872.70 |
| Rate for Payer: Aetna Commercial |
$757.16
|
| Rate for Payer: Aetna Medicare |
$580.50
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS Trust/PPO |
$232.20
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$754.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$872.70
|
| Rate for Payer: Priority Health Narrow Network |
$872.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$603.89
|
| Rate for Payer: UHC Exchange |
$603.89
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$1,203.00
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$132.44 |
| Max. Negotiated Rate |
$1,025.35 |
| Rate for Payer: Aetna Commercial |
$895.18
|
| Rate for Payer: Aetna Medicare |
$601.50
|
| Rate for Payer: BCBS Complete |
$454.23
|
| Rate for Payer: BCBS Trust/PPO |
$132.44
|
| Rate for Payer: BCN Commercial |
$976.37
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Cash Price |
$962.40
|
| Rate for Payer: Meridian Medicaid |
$454.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$432.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$781.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,025.35
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$791.86
|
| Rate for Payer: UHC Exchange |
$791.86
|
| Rate for Payer: UHCCP Medicaid |
$432.60
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$642.60
|
| Rate for Payer: Aetna Medicare |
$2,804.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: ASR ASR |
$692.58
|
| Rate for Payer: ASR Commercial |
$692.58
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$584.69
|
| Rate for Payer: BCN Commercial |
$553.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$671.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$714.00
|
| Rate for Payer: Healthscope Whirlpool |
$692.58
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$642.60
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,084.60
|
| Rate for Payer: PHP Medicaid |
$1,503.04
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$625.61
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$500.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$4,346.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP DNSP |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
