|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
22903
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$714.00 |
| Rate for Payer: Aetna Commercial |
$642.60
|
| Rate for Payer: ASR ASR |
$692.58
|
| Rate for Payer: ASR Commercial |
$692.58
|
| Rate for Payer: BCBS Trust/PPO |
$581.84
|
| Rate for Payer: BCN Commercial |
$553.56
|
| 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: Healthscope Commercial |
$714.00
|
| Rate for Payer: Healthscope Whirlpool |
$692.58
|
| Rate for Payer: Mclaren Commercial |
$642.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.32
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$679.33 |
| Rate for Payer: Aetna Commercial |
$589.34
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.33
|
| Rate for Payer: Priority Health Narrow Network |
$679.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$522.47
|
| Rate for Payer: UHC Exchange |
$522.47
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 22903
|
| Hospital Charge Code |
22903
|
| Min. Negotiated Rate |
$165.89 |
| Max. Negotiated Rate |
$679.33 |
| Rate for Payer: Aetna Commercial |
$589.34
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: BCBS Complete |
$301.04
|
| Rate for Payer: BCBS Trust/PPO |
$165.89
|
| Rate for Payer: BCN Commercial |
$647.01
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Meridian Medicaid |
$301.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.33
|
| Rate for Payer: Priority Health Narrow Network |
$679.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$522.47
|
| Rate for Payer: UHC Exchange |
$522.47
|
| Rate for Payer: UHCCP Medicaid |
$286.70
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$216.50 |
| Max. Negotiated Rate |
$694.90 |
| Rate for Payer: Aetna Commercial |
$444.06
|
| Rate for Payer: Aetna Medicare |
$395.50
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS Trust/PPO |
$216.50
|
| Rate for Payer: BCN Commercial |
$694.90
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$517.00
|
| Rate for Payer: Priority Health Narrow Network |
$517.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$396.72
|
| Rate for Payer: UHC Exchange |
$396.72
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$597.23
|
| Rate for Payer: Aetna Medicare |
$603.00
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.58
|
| Rate for Payer: Priority Health Narrow Network |
$693.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.93
|
| Rate for Payer: UHC Exchange |
$529.93
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
OP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$783.90 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,085.40
|
| 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 |
$1,169.82
|
| Rate for Payer: ASR Commercial |
$1,169.82
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$987.59
|
| Rate for Payer: BCN Commercial |
$935.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$1,133.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,206.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,169.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,085.40
|
| 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 |
$1,025.10
|
| Rate for Payer: Nomi Health Commercial |
$988.92
|
| 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 |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,056.70
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$845.41
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,061.28
|
| 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 FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,206.00
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$291.81 |
| Max. Negotiated Rate |
$1,055.54 |
| Rate for Payer: Aetna Commercial |
$597.23
|
| Rate for Payer: Aetna Medicare |
$603.00
|
| Rate for Payer: BCBS Complete |
$306.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.54
|
| Rate for Payer: BCN Commercial |
$656.79
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Meridian Medicaid |
$306.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.58
|
| Rate for Payer: Priority Health Narrow Network |
$693.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$529.93
|
| Rate for Payer: UHC Exchange |
$529.93
|
| Rate for Payer: UHCCP Medicaid |
$291.81
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Facility
|
IP
|
$1,206.00
|
|
|
Service Code
|
CPT 28041
|
| Hospital Charge Code |
28041
|
| Min. Negotiated Rate |
$783.90 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Aetna Commercial |
$1,085.40
|
| Rate for Payer: ASR ASR |
$1,169.82
|
| Rate for Payer: ASR Commercial |
$1,169.82
|
| Rate for Payer: BCBS Trust/PPO |
$982.77
|
| Rate for Payer: BCN Commercial |
$935.01
|
| Rate for Payer: Cash Price |
$964.80
|
| Rate for Payer: Cofinity Commercial |
$1,133.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.80
|
| Rate for Payer: Healthscope Commercial |
$1,206.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,169.82
|
| Rate for Payer: Mclaren Commercial |
$1,085.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,025.10
|
| Rate for Payer: Nomi Health Commercial |
$988.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,061.28
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$881.00
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$700.27 |
| Rate for Payer: Aetna Commercial |
$458.34
|
| Rate for Payer: Aetna Medicare |
$440.50
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCBS Trust/PPO |
$699.47
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Cash Price |
$704.80
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$572.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.31
|
| Rate for Payer: Priority Health Narrow Network |
$534.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$409.36
|
| Rate for Payer: UHC Exchange |
$409.36
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$1,175.00 |
| Rate for Payer: Aetna Commercial |
$1,057.50
|
| Rate for Payer: ASR ASR |
$1,139.75
|
| Rate for Payer: ASR Commercial |
$1,139.75
|
| Rate for Payer: BCBS Trust/PPO |
$957.51
|
| Rate for Payer: BCN Commercial |
$910.98
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Healthscope Commercial |
$1,175.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.75
|
| Rate for Payer: Mclaren Commercial |
$1,057.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.00
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25075
|
| Hospital Charge Code |
25075
|
| Min. Negotiated Rate |
$207.68 |
| Max. Negotiated Rate |
$1,151.69 |
| Rate for Payer: Aetna Commercial |
$418.59
|
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.69
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$218.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.04
|
| Rate for Payer: Priority Health Narrow Network |
$491.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.60
|
| Rate for Payer: UHC Exchange |
$373.60
|
| Rate for Payer: UHCCP Medicaid |
$207.68
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 25075
|
| Hospital Charge Code |
25075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$1,057.50
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,139.75
|
| Rate for Payer: ASR Commercial |
$1,139.75
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$962.21
|
| Rate for Payer: BCN Commercial |
$910.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cofinity Commercial |
$1,104.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,175.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,139.75
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,057.50
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.75
|
| Rate for Payer: Nomi Health Commercial |
$963.50
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,029.54
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$823.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,175.00
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$207.68 |
| Max. Negotiated Rate |
$1,151.69 |
| Rate for Payer: Aetna Commercial |
$418.59
|
| Rate for Payer: Aetna Medicare |
$587.50
|
| Rate for Payer: BCBS Complete |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,151.69
|
| Rate for Payer: BCN Commercial |
$767.71
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Cash Price |
$940.00
|
| Rate for Payer: Meridian Medicaid |
$218.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$207.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$763.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.04
|
| Rate for Payer: Priority Health Narrow Network |
$491.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.60
|
| Rate for Payer: UHC Exchange |
$373.60
|
| Rate for Payer: UHCCP Medicaid |
$207.68
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 27634
|
| Min. Negotiated Rate |
$434.73 |
| Max. Negotiated Rate |
$1,550.25 |
| Rate for Payer: Aetna Commercial |
$906.06
|
| Rate for Payer: Aetna Medicare |
$1,192.50
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$992.02
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,550.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,035.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,035.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$801.36
|
| Rate for Payer: UHC Exchange |
$801.36
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$1,247.00
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$303.53 |
| Max. Negotiated Rate |
$1,538.94 |
| Rate for Payer: Aetna Commercial |
$613.97
|
| Rate for Payer: Aetna Medicare |
$623.50
|
| Rate for Payer: BCBS Complete |
$318.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,538.94
|
| Rate for Payer: BCN Commercial |
$687.08
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Cash Price |
$997.60
|
| Rate for Payer: Meridian Medicaid |
$318.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$810.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.16
|
| Rate for Payer: Priority Health Narrow Network |
$727.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$583.00
|
| Rate for Payer: UHC Exchange |
$583.00
|
| Rate for Payer: UHCCP Medicaid |
$303.53
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$704.60 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$1,051.48
|
| Rate for Payer: ASR Commercial |
$1,051.48
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$887.69
|
| Rate for Payer: BCN Commercial |
$840.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$1,018.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,084.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,051.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$975.60
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$949.80
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$759.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$953.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Facility
|
IP
|
$1,084.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$704.60 |
| Max. Negotiated Rate |
$1,084.00 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: ASR ASR |
$1,051.48
|
| Rate for Payer: ASR Commercial |
$1,051.48
|
| Rate for Payer: BCBS Trust/PPO |
$883.35
|
| Rate for Payer: BCN Commercial |
$840.43
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cofinity Commercial |
$1,018.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.20
|
| Rate for Payer: Healthscope Commercial |
$1,084.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,051.48
|
| Rate for Payer: Mclaren Commercial |
$975.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$953.92
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$1,125.81 |
| Rate for Payer: Aetna Commercial |
$403.90
|
| Rate for Payer: Aetna Medicare |
$542.00
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.26
|
| Rate for Payer: Priority Health Narrow Network |
$474.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.96
|
| Rate for Payer: UHC Exchange |
$367.96
|
| Rate for Payer: UHCCP Medicaid |
$199.79
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,084.00
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$199.79 |
| Max. Negotiated Rate |
$1,125.81 |
| Rate for Payer: Aetna Commercial |
$403.90
|
| Rate for Payer: Aetna Medicare |
$542.00
|
| Rate for Payer: BCBS Complete |
$209.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.81
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Cash Price |
$867.20
|
| Rate for Payer: Meridian Medicaid |
$209.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$199.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$704.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.26
|
| Rate for Payer: Priority Health Narrow Network |
$474.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$367.96
|
| Rate for Payer: UHC Exchange |
$367.96
|
| Rate for Payer: UHCCP Medicaid |
$199.79
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$640.16 |
| Rate for Payer: Aetna Commercial |
$404.86
|
| Rate for Payer: Aetna Medicare |
$403.00
|
| Rate for Payer: BCBS Complete |
$210.68
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Meridian Medicaid |
$210.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.28
|
| Rate for Payer: Priority Health Narrow Network |
$475.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.07
|
| Rate for Payer: UHC Exchange |
$354.07
|
| Rate for Payer: UHCCP Medicaid |
$200.65
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Hospital Charge Code |
21555
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$640.16 |
| Rate for Payer: Aetna Commercial |
$404.86
|
| Rate for Payer: Aetna Medicare |
$403.00
|
| Rate for Payer: BCBS Complete |
$210.68
|
| Rate for Payer: BCBS Trust/PPO |
$84.68
|
| Rate for Payer: BCN Commercial |
$640.16
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Meridian Medicaid |
$210.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$475.28
|
| Rate for Payer: Priority Health Narrow Network |
$475.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.07
|
| Rate for Payer: UHC Exchange |
$354.07
|
| Rate for Payer: UHCCP Medicaid |
$200.65
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
IP
|
$806.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$523.90 |
| Max. Negotiated Rate |
$806.00 |
| Rate for Payer: Aetna Commercial |
$725.40
|
| Rate for Payer: ASR ASR |
$781.82
|
| Rate for Payer: ASR Commercial |
$781.82
|
| Rate for Payer: BCBS Trust/PPO |
$656.81
|
| Rate for Payer: BCN Commercial |
$624.89
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$757.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.80
|
| Rate for Payer: Healthscope Commercial |
$806.00
|
| Rate for Payer: Healthscope Whirlpool |
$781.82
|
| Rate for Payer: Mclaren Commercial |
$725.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: Nomi Health Commercial |
$660.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$709.28
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Facility
|
OP
|
$806.00
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
21555
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$523.90 |
| Max. Negotiated Rate |
$3,486.93 |
| Rate for Payer: Aetna Commercial |
$725.40
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$781.82
|
| Rate for Payer: ASR Commercial |
$781.82
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$660.03
|
| Rate for Payer: BCN Commercial |
$624.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$757.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$644.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$806.00
|
| Rate for Payer: Healthscope Whirlpool |
$781.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$725.40
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: Nomi Health Commercial |
$660.92
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,486.93
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,789.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$709.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Facility
|
IP
|
$2,144.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,393.60 |
| Max. Negotiated Rate |
$2,144.00 |
| Rate for Payer: Aetna Commercial |
$1,929.60
|
| Rate for Payer: ASR ASR |
$2,079.68
|
| Rate for Payer: ASR Commercial |
$2,079.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,747.15
|
| Rate for Payer: BCN Commercial |
$1,662.24
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$2,015.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,715.20
|
| Rate for Payer: Healthscope Commercial |
$2,144.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,079.68
|
| Rate for Payer: Mclaren Commercial |
$1,929.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,822.40
|
| Rate for Payer: Nomi Health Commercial |
$1,758.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,886.72
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$240.88 |
| Max. Negotiated Rate |
$1,393.60 |
| Rate for Payer: Aetna Commercial |
$976.70
|
| Rate for Payer: Aetna Medicare |
$1,072.00
|
| Rate for Payer: BCBS Complete |
$497.40
|
| Rate for Payer: BCBS Trust/PPO |
$240.88
|
| Rate for Payer: BCN Commercial |
$1,072.16
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Meridian Medicaid |
$497.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$473.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,124.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,124.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$877.38
|
| Rate for Payer: UHC Exchange |
$877.38
|
| Rate for Payer: UHCCP Medicaid |
$473.71
|
|
