|
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
|
Facility
|
OP
|
$1,084.00
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
27618
|
| Min. Negotiated Rate |
$704.60 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$975.60
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$1,051.48
|
| Rate for Payer: ASR Commercial |
$1,051.48
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$887.69
|
| Rate for Payer: BCN Commercial |
$840.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,084.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,051.48
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$975.60
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$921.40
|
| Rate for Payer: Nomi Health Commercial |
$888.88
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| 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 |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$759.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$953.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
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 |
$295.85 |
| Max. Negotiated Rate |
$523.90 |
| Rate for Payer: Aetna Commercial |
$396.44
|
| Rate for Payer: Aetna Medicare |
$295.85
|
| Rate for Payer: BCBS Complete |
$322.40
|
| Rate for Payer: BCBS MAPPO |
$295.85
|
| Rate for Payer: BCN Medicare Advantage |
$295.85
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$426.02
|
| Rate for Payer: Cofinity Commercial |
$396.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.85
|
| Rate for Payer: Healthscope Commercial |
$355.02
|
| Rate for Payer: Healthscope Whirlpool |
$355.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.64
|
| Rate for Payer: Nomi Health Commercial |
$355.02
|
| Rate for Payer: PACE SWMI |
$295.85
|
| Rate for Payer: PHP Medicare Advantage |
$295.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health Medicare |
$295.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.85
|
| Rate for Payer: UHC Medicare Advantage |
$295.85
|
| Rate for Payer: UHCCP DNSP |
$295.85
|
|
|
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 |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$725.40
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$781.82
|
| Rate for Payer: ASR Commercial |
$781.82
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$660.03
|
| Rate for Payer: BCN Commercial |
$624.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| 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 |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$806.00
|
| Rate for Payer: Healthscope Whirlpool |
$781.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$725.40
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.10
|
| Rate for Payer: Nomi Health Commercial |
$660.92
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$706.22
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$565.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$709.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$523.90 |
| Rate for Payer: Aetna Commercial |
$396.44
|
| Rate for Payer: Aetna Medicare |
$295.85
|
| Rate for Payer: BCBS Complete |
$322.40
|
| Rate for Payer: BCBS MAPPO |
$295.85
|
| Rate for Payer: BCN Medicare Advantage |
$295.85
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$426.02
|
| Rate for Payer: Cofinity Commercial |
$396.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.85
|
| Rate for Payer: Healthscope Commercial |
$355.02
|
| Rate for Payer: Healthscope Whirlpool |
$355.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.64
|
| Rate for Payer: Nomi Health Commercial |
$355.02
|
| Rate for Payer: PACE SWMI |
$295.85
|
| Rate for Payer: PHP Medicare Advantage |
$295.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.90
|
| Rate for Payer: Priority Health Medicare |
$295.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.85
|
| Rate for Payer: UHC Medicare Advantage |
$295.85
|
| Rate for Payer: UHCCP DNSP |
$295.85
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$707.57 |
| Max. Negotiated Rate |
$1,393.60 |
| Rate for Payer: Aetna Commercial |
$948.14
|
| Rate for Payer: Aetna Medicare |
$707.57
|
| Rate for Payer: BCBS Complete |
$857.60
|
| Rate for Payer: BCBS MAPPO |
$707.57
|
| Rate for Payer: BCN Medicare Advantage |
$707.57
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$948.14
|
| Rate for Payer: Cofinity Commercial |
$1,018.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.57
|
| Rate for Payer: Healthscope Commercial |
$849.08
|
| Rate for Payer: Healthscope Whirlpool |
$849.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.95
|
| Rate for Payer: Nomi Health Commercial |
$849.08
|
| Rate for Payer: PACE SWMI |
$707.57
|
| Rate for Payer: PHP Medicare Advantage |
$707.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health Medicare |
$707.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.57
|
| Rate for Payer: UHC Medicare Advantage |
$707.57
|
| Rate for Payer: UHCCP DNSP |
$707.57
|
|
|
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/>
|
Facility
|
OP
|
$2,144.00
|
|
|
Service Code
|
CPT 21554
|
| Hospital Charge Code |
21554
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,393.60 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,929.60
|
| 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 |
$2,079.68
|
| Rate for Payer: ASR Commercial |
$2,079.68
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.72
|
| Rate for Payer: BCN Commercial |
$1,662.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,715.20
|
| 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: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,144.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,079.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,929.60
|
| 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 |
$1,822.40
|
| Rate for Payer: Nomi Health Commercial |
$1,758.08
|
| 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 |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,878.57
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,502.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,886.72
|
| 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 TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
21554
|
| Min. Negotiated Rate |
$707.57 |
| Max. Negotiated Rate |
$1,393.60 |
| Rate for Payer: Aetna Commercial |
$948.14
|
| Rate for Payer: Aetna Medicare |
$707.57
|
| Rate for Payer: BCBS Complete |
$857.60
|
| Rate for Payer: BCBS MAPPO |
$707.57
|
| Rate for Payer: BCN Medicare Advantage |
$707.57
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cash Price |
$1,715.20
|
| Rate for Payer: Cofinity Commercial |
$948.14
|
| Rate for Payer: Cofinity Commercial |
$1,018.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$707.57
|
| Rate for Payer: Healthscope Commercial |
$849.08
|
| Rate for Payer: Healthscope Whirlpool |
$849.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.95
|
| Rate for Payer: Nomi Health Commercial |
$849.08
|
| Rate for Payer: PACE SWMI |
$707.57
|
| Rate for Payer: PHP Medicare Advantage |
$707.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,393.60
|
| Rate for Payer: Priority Health Medicare |
$707.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$707.57
|
| Rate for Payer: UHC Medicare Advantage |
$707.57
|
| Rate for Payer: UHCCP DNSP |
$707.57
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$507.60 |
| Max. Negotiated Rate |
$856.96 |
| Rate for Payer: Aetna Commercial |
$797.45
|
| Rate for Payer: Aetna Medicare |
$595.11
|
| Rate for Payer: BCBS Complete |
$507.60
|
| Rate for Payer: BCBS MAPPO |
$595.11
|
| Rate for Payer: BCN Medicare Advantage |
$595.11
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$856.96
|
| Rate for Payer: Cofinity Commercial |
$797.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.11
|
| Rate for Payer: Healthscope Commercial |
$714.13
|
| Rate for Payer: Healthscope Whirlpool |
$714.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.87
|
| Rate for Payer: Nomi Health Commercial |
$714.13
|
| Rate for Payer: PACE SWMI |
$595.11
|
| Rate for Payer: PHP Medicare Advantage |
$595.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health Medicare |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.11
|
| Rate for Payer: UHC Medicare Advantage |
$595.11
|
| Rate for Payer: UHCCP DNSP |
$595.11
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
IP
|
$1,269.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$824.85 |
| Max. Negotiated Rate |
$1,269.00 |
| Rate for Payer: Aetna Commercial |
$1,142.10
|
| Rate for Payer: ASR ASR |
$1,230.93
|
| Rate for Payer: ASR Commercial |
$1,230.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.11
|
| Rate for Payer: BCN Commercial |
$983.86
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$1,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.20
|
| Rate for Payer: Healthscope Commercial |
$1,269.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.93
|
| Rate for Payer: Mclaren Commercial |
$1,142.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,078.65
|
| Rate for Payer: Nomi Health Commercial |
$1,040.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.72
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Facility
|
OP
|
$1,269.00
|
|
|
Service Code
|
CPT 27048
|
| Hospital Charge Code |
27048
|
| Min. Negotiated Rate |
$824.85 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,142.10
|
| 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 |
$1,230.93
|
| Rate for Payer: ASR Commercial |
$1,230.93
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.18
|
| Rate for Payer: BCN Commercial |
$983.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$1,192.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,015.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,269.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,142.10
|
| 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 |
$1,078.65
|
| Rate for Payer: Nomi Health Commercial |
$1,040.58
|
| 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 |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.90
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$889.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.72
|
| 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 TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$507.60 |
| Max. Negotiated Rate |
$856.96 |
| Rate for Payer: Aetna Commercial |
$797.45
|
| Rate for Payer: Aetna Medicare |
$595.11
|
| Rate for Payer: BCBS Complete |
$507.60
|
| Rate for Payer: BCBS MAPPO |
$595.11
|
| Rate for Payer: BCN Medicare Advantage |
$595.11
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$856.96
|
| Rate for Payer: Cofinity Commercial |
$797.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$595.11
|
| Rate for Payer: Healthscope Commercial |
$714.13
|
| Rate for Payer: Healthscope Whirlpool |
$714.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.87
|
| Rate for Payer: Nomi Health Commercial |
$714.13
|
| Rate for Payer: PACE SWMI |
$595.11
|
| Rate for Payer: PHP Medicare Advantage |
$595.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health Medicare |
$595.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$595.11
|
| Rate for Payer: UHC Medicare Advantage |
$595.11
|
| Rate for Payer: UHCCP DNSP |
$595.11
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$1,399.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$559.60 |
| Max. Negotiated Rate |
$1,023.57 |
| Rate for Payer: Aetna Commercial |
$952.49
|
| Rate for Payer: Aetna Medicare |
$710.81
|
| Rate for Payer: BCBS Complete |
$559.60
|
| Rate for Payer: BCBS MAPPO |
$710.81
|
| Rate for Payer: BCN Medicare Advantage |
$710.81
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cofinity Commercial |
$952.49
|
| Rate for Payer: Cofinity Commercial |
$1,023.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.81
|
| Rate for Payer: Healthscope Commercial |
$852.97
|
| Rate for Payer: Healthscope Whirlpool |
$852.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$746.35
|
| Rate for Payer: Nomi Health Commercial |
$852.97
|
| Rate for Payer: PACE SWMI |
$710.81
|
| Rate for Payer: PHP Medicare Advantage |
$710.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.35
|
| Rate for Payer: Priority Health Medicare |
$710.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$710.81
|
| Rate for Payer: UHC Medicare Advantage |
$710.81
|
| Rate for Payer: UHCCP DNSP |
$710.81
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$522.60 |
| Rate for Payer: Aetna Commercial |
$468.28
|
| Rate for Payer: Aetna Medicare |
$349.46
|
| Rate for Payer: BCBS Complete |
$321.60
|
| Rate for Payer: BCBS MAPPO |
$349.46
|
| Rate for Payer: BCN Medicare Advantage |
$349.46
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$503.22
|
| Rate for Payer: Cofinity Commercial |
$468.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.46
|
| Rate for Payer: Healthscope Commercial |
$419.35
|
| Rate for Payer: Healthscope Whirlpool |
$419.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.93
|
| Rate for Payer: Nomi Health Commercial |
$419.35
|
| Rate for Payer: PACE SWMI |
$349.46
|
| Rate for Payer: PHP Medicare Advantage |
$349.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health Medicare |
$349.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.46
|
| Rate for Payer: UHC Medicare Advantage |
$349.46
|
| Rate for Payer: UHCCP DNSP |
$349.46
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$634.80 |
| Max. Negotiated Rate |
$1,031.55 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$674.92
|
| Rate for Payer: BCBS Complete |
$634.80
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Healthscope Commercial |
$809.90
|
| Rate for Payer: Healthscope Whirlpool |
$809.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health Medicare |
$674.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.92
|
| Rate for Payer: UHC Medicare Advantage |
$674.92
|
| Rate for Payer: UHCCP DNSP |
$674.92
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Hospital Charge Code |
23073
|
| Min. Negotiated Rate |
$634.80 |
| Max. Negotiated Rate |
$1,031.55 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Aetna Medicare |
$674.92
|
| Rate for Payer: BCBS Complete |
$634.80
|
| Rate for Payer: BCBS MAPPO |
$674.92
|
| Rate for Payer: BCN Medicare Advantage |
$674.92
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$971.88
|
| Rate for Payer: Cofinity Commercial |
$904.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$674.92
|
| Rate for Payer: Healthscope Commercial |
$809.90
|
| Rate for Payer: Healthscope Whirlpool |
$809.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$708.67
|
| Rate for Payer: Nomi Health Commercial |
$809.90
|
| Rate for Payer: PACE SWMI |
$674.92
|
| Rate for Payer: PHP Medicare Advantage |
$674.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health Medicare |
$674.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$674.92
|
| Rate for Payer: UHC Medicare Advantage |
$674.92
|
| Rate for Payer: UHCCP DNSP |
$674.92
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
OP
|
$1,587.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,031.55 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,428.30
|
| 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 |
$1,539.39
|
| Rate for Payer: ASR Commercial |
$1,539.39
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,299.59
|
| Rate for Payer: BCN Commercial |
$1,230.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,587.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,539.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,428.30
|
| 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 |
$1,348.95
|
| Rate for Payer: Nomi Health Commercial |
$1,301.34
|
| 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 |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,390.53
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.56
|
| 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 TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Facility
|
IP
|
$1,587.00
|
|
|
Service Code
|
CPT 23073
|
| Hospital Charge Code |
23073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,031.55 |
| Max. Negotiated Rate |
$1,587.00 |
| Rate for Payer: Aetna Commercial |
$1,428.30
|
| Rate for Payer: ASR ASR |
$1,539.39
|
| Rate for Payer: ASR Commercial |
$1,539.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,293.25
|
| Rate for Payer: BCN Commercial |
$1,230.40
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,269.60
|
| Rate for Payer: Healthscope Commercial |
$1,587.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,539.39
|
| Rate for Payer: Mclaren Commercial |
$1,428.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,348.95
|
| Rate for Payer: Nomi Health Commercial |
$1,301.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.56
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$731.40 |
| Max. Negotiated Rate |
$2,129.40 |
| Rate for Payer: Aetna Commercial |
$980.08
|
| Rate for Payer: Aetna Medicare |
$731.40
|
| Rate for Payer: BCBS Complete |
$1,310.40
|
| Rate for Payer: BCBS MAPPO |
$731.40
|
| Rate for Payer: BCN Medicare Advantage |
$731.40
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cofinity Commercial |
$980.08
|
| Rate for Payer: Cofinity Commercial |
$1,053.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.40
|
| Rate for Payer: Healthscope Commercial |
$877.68
|
| Rate for Payer: Healthscope Whirlpool |
$877.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.97
|
| Rate for Payer: Nomi Health Commercial |
$877.68
|
| Rate for Payer: PACE SWMI |
$731.40
|
| Rate for Payer: PHP Medicare Advantage |
$731.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health Medicare |
$731.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.40
|
| Rate for Payer: UHC Medicare Advantage |
$731.40
|
| Rate for Payer: UHCCP DNSP |
$731.40
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,748.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$603.53 |
| Max. Negotiated Rate |
$1,136.20 |
| Rate for Payer: Aetna Commercial |
$808.73
|
| Rate for Payer: Aetna Medicare |
$603.53
|
| Rate for Payer: BCBS Complete |
$699.20
|
| Rate for Payer: BCBS MAPPO |
$603.53
|
| Rate for Payer: BCN Medicare Advantage |
$603.53
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cofinity Commercial |
$869.08
|
| Rate for Payer: Cofinity Commercial |
$808.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.53
|
| Rate for Payer: Healthscope Commercial |
$724.24
|
| Rate for Payer: Healthscope Whirlpool |
$724.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.71
|
| Rate for Payer: Nomi Health Commercial |
$724.24
|
| Rate for Payer: PACE SWMI |
$603.53
|
| Rate for Payer: PHP Medicare Advantage |
$603.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.20
|
| Rate for Payer: Priority Health Medicare |
$603.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.53
|
| Rate for Payer: UHC Medicare Advantage |
$603.53
|
| Rate for Payer: UHCCP DNSP |
$603.53
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$527.45
|
| Rate for Payer: Aetna Medicare |
$393.62
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$393.62
|
| Rate for Payer: BCN Medicare Advantage |
$393.62
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$566.81
|
| Rate for Payer: Cofinity Commercial |
$527.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.62
|
| Rate for Payer: Healthscope Commercial |
$472.34
|
| Rate for Payer: Healthscope Whirlpool |
$472.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.30
|
| Rate for Payer: Nomi Health Commercial |
$472.34
|
| Rate for Payer: PACE SWMI |
$393.62
|
| Rate for Payer: PHP Medicare Advantage |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$393.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.62
|
| Rate for Payer: UHC Medicare Advantage |
$393.62
|
| Rate for Payer: UHCCP DNSP |
$393.62
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Hospital Charge Code |
24071
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$527.45
|
| Rate for Payer: Aetna Medicare |
$393.62
|
| Rate for Payer: BCBS Complete |
$622.80
|
| Rate for Payer: BCBS MAPPO |
$393.62
|
| Rate for Payer: BCN Medicare Advantage |
$393.62
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$566.81
|
| Rate for Payer: Cofinity Commercial |
$527.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.62
|
| Rate for Payer: Healthscope Commercial |
$472.34
|
| Rate for Payer: Healthscope Whirlpool |
$472.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.30
|
| Rate for Payer: Nomi Health Commercial |
$472.34
|
| Rate for Payer: PACE SWMI |
$393.62
|
| Rate for Payer: PHP Medicare Advantage |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health Medicare |
$393.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.62
|
| Rate for Payer: UHC Medicare Advantage |
$393.62
|
| Rate for Payer: UHCCP DNSP |
$393.62
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$1,557.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,012.05 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$1,401.30
|
| 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 |
$1,510.29
|
| Rate for Payer: ASR Commercial |
$1,510.29
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.03
|
| Rate for Payer: BCN Commercial |
$1,207.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,463.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$1,557.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,510.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$1,401.30
|
| 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 |
$1,323.45
|
| Rate for Payer: Nomi Health Commercial |
$1,276.74
|
| 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 |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,364.24
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,091.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,370.16
|
| 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
|
|
