|
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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,929.60
|
| 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 |
$2,079.68
|
| Rate for Payer: ASR Commercial |
$2,079.68
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.72
|
| Rate for Payer: BCN Commercial |
$1,662.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$2,144.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,079.68
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,929.60
|
| 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 |
$1,822.40
|
| Rate for Payer: Nomi Health Commercial |
$1,758.08
|
| 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 |
$1,393.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,878.57
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,502.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,886.72
|
| 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 NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,144.00
|
|
|
Service Code
|
HCPCS 21554
|
| Hospital Charge Code |
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
|
|
|
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 |
$399.80 |
| Max. Negotiated Rate |
$4,154.02 |
| Rate for Payer: Aetna Commercial |
$818.66
|
| Rate for Payer: Aetna Medicare |
$634.50
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,154.02
|
| Rate for Payer: BCN Commercial |
$899.16
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$944.96
|
| Rate for Payer: Priority Health Narrow Network |
$944.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$677.09
|
| Rate for Payer: UHC Exchange |
$677.09
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
|
|
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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,142.10
|
| 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 |
$1,230.93
|
| Rate for Payer: ASR Commercial |
$1,230.93
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.18
|
| Rate for Payer: BCN Commercial |
$983.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,269.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,230.93
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,142.10
|
| 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 |
$1,078.65
|
| Rate for Payer: Nomi Health Commercial |
$1,040.58
|
| 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 |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,111.90
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$889.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,116.72
|
| 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 PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$399.80 |
| Max. Negotiated Rate |
$4,154.02 |
| Rate for Payer: Aetna Commercial |
$818.66
|
| Rate for Payer: Aetna Medicare |
$634.50
|
| Rate for Payer: BCBS Complete |
$419.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,154.02
|
| Rate for Payer: BCN Commercial |
$899.16
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Meridian Medicaid |
$419.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$944.96
|
| Rate for Payer: Priority Health Narrow Network |
$944.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$677.09
|
| Rate for Payer: UHC Exchange |
$677.09
|
| Rate for Payer: UHCCP Medicaid |
$399.80
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$1,399.00
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$137.89 |
| Max. Negotiated Rate |
$1,127.63 |
| Rate for Payer: Aetna Commercial |
$985.74
|
| Rate for Payer: Aetna Medicare |
$699.50
|
| Rate for Payer: BCBS Complete |
$499.86
|
| Rate for Payer: BCBS Trust/PPO |
$137.89
|
| Rate for Payer: BCN Commercial |
$1,079.00
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Cash Price |
$1,119.20
|
| Rate for Payer: Meridian Medicaid |
$499.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,127.63
|
| Rate for Payer: Priority Health Narrow Network |
$1,127.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$888.29
|
| Rate for Payer: UHC Exchange |
$888.29
|
| Rate for Payer: UHCCP Medicaid |
$476.06
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$235.58 |
| Max. Negotiated Rate |
$3,876.14 |
| Rate for Payer: Aetna Commercial |
$478.89
|
| Rate for Payer: Aetna Medicare |
$402.00
|
| Rate for Payer: BCBS Complete |
$247.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,876.14
|
| Rate for Payer: BCN Commercial |
$728.62
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Meridian Medicaid |
$247.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.26
|
| Rate for Payer: Priority Health Narrow Network |
$560.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$448.62
|
| Rate for Payer: UHC Exchange |
$448.62
|
| Rate for Payer: UHCCP Medicaid |
$235.58
|
|
|
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 |
$453.05 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Aetna Commercial |
$933.13
|
| Rate for Payer: Aetna Medicare |
$793.50
|
| Rate for Payer: BCBS Complete |
$475.70
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Meridian Medicaid |
$475.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$822.76
|
| Rate for Payer: UHC Exchange |
$822.76
|
| Rate for Payer: UHCCP Medicaid |
$453.05
|
|
|
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 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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,428.30
|
| 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 |
$1,539.39
|
| Rate for Payer: ASR Commercial |
$1,539.39
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,299.59
|
| Rate for Payer: BCN Commercial |
$1,230.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,587.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,539.39
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,428.30
|
| 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 |
$1,348.95
|
| Rate for Payer: Nomi Health Commercial |
$1,301.34
|
| 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 |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,390.53
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,396.56
|
| 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 SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$1,587.00
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$453.05 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Aetna Commercial |
$933.13
|
| Rate for Payer: Aetna Medicare |
$793.50
|
| Rate for Payer: BCBS Complete |
$475.70
|
| Rate for Payer: BCBS Trust/PPO |
$464.38
|
| Rate for Payer: BCN Commercial |
$1,023.29
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Cash Price |
$1,269.60
|
| Rate for Payer: Meridian Medicaid |
$475.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,073.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,073.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$822.76
|
| Rate for Payer: UHC Exchange |
$822.76
|
| Rate for Payer: UHCCP Medicaid |
$453.05
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,276.00
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$490.33 |
| Max. Negotiated Rate |
$2,129.40 |
| Rate for Payer: Aetna Commercial |
$1,008.38
|
| Rate for Payer: Aetna Medicare |
$1,638.00
|
| Rate for Payer: BCBS Complete |
$514.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.52
|
| Rate for Payer: BCN Commercial |
$1,104.90
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Meridian Medicaid |
$514.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,163.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,163.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$897.23
|
| Rate for Payer: UHC Exchange |
$897.23
|
| Rate for Payer: UHCCP Medicaid |
$490.33
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$1,748.00
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$1,529.96 |
| Rate for Payer: Aetna Commercial |
$832.30
|
| Rate for Payer: Aetna Medicare |
$874.00
|
| Rate for Payer: BCBS Complete |
$426.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.96
|
| Rate for Payer: BCN Commercial |
$917.25
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Meridian Medicaid |
$426.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,136.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$963.79
|
| Rate for Payer: Priority Health Narrow Network |
$963.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$662.20
|
| Rate for Payer: UHC Exchange |
$662.20
|
| Rate for Payer: UHCCP Medicaid |
$405.77
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$1,557.00
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
24071
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,012.05 |
| Max. Negotiated Rate |
$1,557.00 |
| Rate for Payer: Aetna Commercial |
$1,401.30
|
| Rate for Payer: ASR ASR |
$1,510.29
|
| Rate for Payer: ASR Commercial |
$1,510.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,268.80
|
| Rate for Payer: BCN Commercial |
$1,207.14
|
| 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: Healthscope Commercial |
$1,557.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,510.29
|
| Rate for Payer: Mclaren Commercial |
$1,401.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,323.45
|
| Rate for Payer: Nomi Health Commercial |
$1,276.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,370.16
|
|
|
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 |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,401.30
|
| 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 |
$1,510.29
|
| Rate for Payer: ASR Commercial |
$1,510.29
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.03
|
| Rate for Payer: BCN Commercial |
$1,207.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,557.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,510.29
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,401.30
|
| 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 |
$1,323.45
|
| Rate for Payer: Nomi Health Commercial |
$1,276.74
|
| 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 |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,364.24
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,091.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,370.16
|
| 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 UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$542.43
|
| Rate for Payer: Aetna Medicare |
$778.50
|
| Rate for Payer: BCBS Complete |
$278.00
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$596.19
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Meridian Medicaid |
$278.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.91
|
| Rate for Payer: Priority Health Narrow Network |
$626.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$481.93
|
| Rate for Payer: UHC Exchange |
$481.93
|
| Rate for Payer: UHCCP Medicaid |
$264.76
|
|
|
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 |
$173.81 |
| Max. Negotiated Rate |
$1,012.05 |
| Rate for Payer: Aetna Commercial |
$542.43
|
| Rate for Payer: Aetna Medicare |
$778.50
|
| Rate for Payer: BCBS Complete |
$278.00
|
| Rate for Payer: BCBS Trust/PPO |
$173.81
|
| Rate for Payer: BCN Commercial |
$596.19
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Meridian Medicaid |
$278.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,012.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.91
|
| Rate for Payer: Priority Health Narrow Network |
$626.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$481.93
|
| Rate for Payer: UHC Exchange |
$481.93
|
| Rate for Payer: UHCCP Medicaid |
$264.76
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$843.05 |
| Rate for Payer: Aetna Commercial |
$437.22
|
| Rate for Payer: Aetna Medicare |
$648.50
|
| Rate for Payer: BCBS Complete |
$227.01
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Meridian Medicaid |
$227.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.41
|
| Rate for Payer: Priority Health Narrow Network |
$511.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$368.42
|
| Rate for Payer: UHC Exchange |
$368.42
|
| Rate for Payer: UHCCP Medicaid |
$216.20
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$843.05 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Aetna Commercial |
$1,167.30
|
| Rate for Payer: ASR ASR |
$1,258.09
|
| Rate for Payer: ASR Commercial |
$1,258.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,056.93
|
| Rate for Payer: BCN Commercial |
$1,005.56
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,219.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Healthscope Commercial |
$1,297.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,258.09
|
| Rate for Payer: Mclaren Commercial |
$1,167.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.45
|
| Rate for Payer: Nomi Health Commercial |
$1,063.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,141.36
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$1,297.00
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
24075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$843.05 |
| Max. Negotiated Rate |
$2,734.04 |
| Rate for Payer: Aetna Commercial |
$1,167.30
|
| 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 |
$1,258.09
|
| Rate for Payer: ASR Commercial |
$1,258.09
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.11
|
| Rate for Payer: BCN Commercial |
$1,005.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$1,219.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,297.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,258.09
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$1,167.30
|
| 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 |
$1,102.45
|
| Rate for Payer: Nomi Health Commercial |
$1,063.54
|
| 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 |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,734.04
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,187.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,141.36
|
| 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 TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 24075
|
| Hospital Charge Code |
24075
|
| Min. Negotiated Rate |
$116.31 |
| Max. Negotiated Rate |
$843.05 |
| Rate for Payer: Aetna Commercial |
$437.22
|
| Rate for Payer: Aetna Medicare |
$648.50
|
| Rate for Payer: BCBS Complete |
$227.01
|
| Rate for Payer: BCBS Trust/PPO |
$116.31
|
| Rate for Payer: BCN Commercial |
$787.75
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Meridian Medicaid |
$227.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.41
|
| Rate for Payer: Priority Health Narrow Network |
$511.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$368.42
|
| Rate for Payer: UHC Exchange |
$368.42
|
| Rate for Payer: UHCCP Medicaid |
$216.20
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
IP
|
$1,693.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,100.45 |
| Max. Negotiated Rate |
$1,693.00 |
| Rate for Payer: Aetna Commercial |
$1,523.70
|
| Rate for Payer: ASR ASR |
$1,642.21
|
| Rate for Payer: ASR Commercial |
$1,642.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.63
|
| Rate for Payer: BCN Commercial |
$1,312.58
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$1,591.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.40
|
| Rate for Payer: Healthscope Commercial |
$1,693.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,642.21
|
| Rate for Payer: Mclaren Commercial |
$1,523.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,439.05
|
| Rate for Payer: Nomi Health Commercial |
$1,388.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,489.84
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Facility
|
OP
|
$1,693.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
24073
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,100.45 |
| Max. Negotiated Rate |
$4,346.48 |
| Rate for Payer: Aetna Commercial |
$1,523.70
|
| 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 |
$1,642.21
|
| Rate for Payer: ASR Commercial |
$1,642.21
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,386.40
|
| Rate for Payer: BCN Commercial |
$1,312.58
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cofinity Commercial |
$1,591.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,354.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$1,693.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,642.21
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,804.18
|
| Rate for Payer: Mclaren Commercial |
$1,523.70
|
| 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 |
$1,439.05
|
| Rate for Payer: Nomi Health Commercial |
$1,388.26
|
| 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 |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,483.41
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$1,186.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,489.84
|
| 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 UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$1,693.00
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
24073
|
| Min. Negotiated Rate |
$293.21 |
| Max. Negotiated Rate |
$1,100.45 |
| Rate for Payer: Aetna Commercial |
$928.71
|
| Rate for Payer: Aetna Medicare |
$846.50
|
| Rate for Payer: BCBS Complete |
$473.69
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$1,017.43
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Cash Price |
$1,354.40
|
| Rate for Payer: Meridian Medicaid |
$473.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,100.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,067.59
|
| Rate for Payer: Priority Health Narrow Network |
$1,067.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$826.90
|
| Rate for Payer: UHC Exchange |
$826.90
|
| Rate for Payer: UHCCP Medicaid |
$451.13
|
|
