|
PR RAD RESCJ TUMOR SOFT TISS UPPER ARM/ELBOW 5CM+
|
Professional
|
Both
|
$3,117.00
|
|
|
Service Code
|
HCPCS 24079
|
| Min. Negotiated Rate |
$1,246.80 |
| Max. Negotiated Rate |
$2,026.05 |
| Rate for Payer: Aetna Commercial |
$1,720.75
|
| Rate for Payer: Aetna Medicare |
$1,284.14
|
| Rate for Payer: BCBS Complete |
$1,246.80
|
| Rate for Payer: BCBS MAPPO |
$1,284.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,284.14
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cash Price |
$2,493.60
|
| Rate for Payer: Cofinity Commercial |
$1,849.16
|
| Rate for Payer: Cofinity Commercial |
$1,720.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,284.14
|
| Rate for Payer: Healthscope Commercial |
$1,540.97
|
| Rate for Payer: Healthscope Whirlpool |
$1,540.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,348.35
|
| Rate for Payer: Nomi Health Commercial |
$1,540.97
|
| Rate for Payer: PACE SWMI |
$1,284.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,284.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,026.05
|
| Rate for Payer: Priority Health Medicare |
$1,284.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,284.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,284.14
|
| Rate for Payer: UHCCP DNSP |
$1,284.14
|
|
|
PR RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>
|
Professional
|
Both
|
$3,940.00
|
|
|
Service Code
|
HCPCS 25078
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$2,561.00 |
| Rate for Payer: Aetna Commercial |
$1,512.06
|
| Rate for Payer: Aetna Medicare |
$1,128.40
|
| Rate for Payer: BCBS Complete |
$1,576.00
|
| Rate for Payer: BCBS MAPPO |
$1,128.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,128.40
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cash Price |
$3,152.00
|
| Rate for Payer: Cofinity Commercial |
$1,624.90
|
| Rate for Payer: Cofinity Commercial |
$1,512.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,128.40
|
| Rate for Payer: Healthscope Commercial |
$1,354.08
|
| Rate for Payer: Healthscope Whirlpool |
$1,354.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,184.82
|
| Rate for Payer: Nomi Health Commercial |
$1,354.08
|
| Rate for Payer: PACE SWMI |
$1,128.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,128.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,561.00
|
| Rate for Payer: Priority Health Medicare |
$1,128.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,128.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,128.40
|
| Rate for Payer: UHCCP DNSP |
$1,128.40
|
|
|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$3,509.00
|
|
|
Service Code
|
HCPCS 26118
|
| Min. Negotiated Rate |
$1,015.82 |
| Max. Negotiated Rate |
$2,280.85 |
| Rate for Payer: Aetna Commercial |
$1,361.20
|
| Rate for Payer: Aetna Medicare |
$1,015.82
|
| Rate for Payer: BCBS Complete |
$1,403.60
|
| Rate for Payer: BCBS MAPPO |
$1,015.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.82
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cash Price |
$2,807.20
|
| Rate for Payer: Cofinity Commercial |
$1,462.78
|
| Rate for Payer: Cofinity Commercial |
$1,361.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.82
|
| Rate for Payer: Healthscope Commercial |
$1,218.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,218.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.61
|
| Rate for Payer: Nomi Health Commercial |
$1,218.98
|
| Rate for Payer: PACE SWMI |
$1,015.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,280.85
|
| Rate for Payer: Priority Health Medicare |
$1,015.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,015.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.82
|
| Rate for Payer: UHCCP DNSP |
$1,015.82
|
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$4,271.00
|
|
|
Service Code
|
HCPCS 27075
|
| Min. Negotiated Rate |
$1,708.40 |
| Max. Negotiated Rate |
$2,884.19 |
| Rate for Payer: Aetna Commercial |
$2,683.90
|
| Rate for Payer: Aetna Medicare |
$2,002.91
|
| Rate for Payer: BCBS Complete |
$1,708.40
|
| Rate for Payer: BCBS MAPPO |
$2,002.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,002.91
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cash Price |
$3,416.80
|
| Rate for Payer: Cofinity Commercial |
$2,884.19
|
| Rate for Payer: Cofinity Commercial |
$2,683.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,002.91
|
| Rate for Payer: Healthscope Commercial |
$2,403.49
|
| Rate for Payer: Healthscope Whirlpool |
$2,403.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,103.06
|
| Rate for Payer: Nomi Health Commercial |
$2,403.49
|
| Rate for Payer: PACE SWMI |
$2,002.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,002.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.15
|
| Rate for Payer: Priority Health Medicare |
$2,002.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,002.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,002.91
|
| Rate for Payer: UHCCP DNSP |
$2,002.91
|
|
|
PR RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$1,646.00
|
|
|
Service Code
|
HCPCS 26260
|
| Min. Negotiated Rate |
$658.40 |
| Max. Negotiated Rate |
$1,109.89 |
| Rate for Payer: Aetna Commercial |
$1,032.82
|
| Rate for Payer: Aetna Medicare |
$770.76
|
| Rate for Payer: BCBS Complete |
$658.40
|
| Rate for Payer: BCBS MAPPO |
$770.76
|
| Rate for Payer: BCN Medicare Advantage |
$770.76
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cash Price |
$1,316.80
|
| Rate for Payer: Cofinity Commercial |
$1,109.89
|
| Rate for Payer: Cofinity Commercial |
$1,032.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.76
|
| Rate for Payer: Healthscope Commercial |
$924.91
|
| Rate for Payer: Healthscope Whirlpool |
$924.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.30
|
| Rate for Payer: Nomi Health Commercial |
$924.91
|
| Rate for Payer: PACE SWMI |
$770.76
|
| Rate for Payer: PHP Medicare Advantage |
$770.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.90
|
| Rate for Payer: Priority Health Medicare |
$770.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.76
|
| Rate for Payer: UHC Medicare Advantage |
$770.76
|
| Rate for Payer: UHCCP DNSP |
$770.76
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>
|
Professional
|
Both
|
$1,757.00
|
|
|
Service Code
|
HCPCS 21016
|
| Min. Negotiated Rate |
$702.80 |
| Max. Negotiated Rate |
$1,388.45 |
| Rate for Payer: Aetna Commercial |
$1,292.03
|
| Rate for Payer: Aetna Medicare |
$964.20
|
| Rate for Payer: BCBS Complete |
$702.80
|
| Rate for Payer: BCBS MAPPO |
$964.20
|
| Rate for Payer: BCN Medicare Advantage |
$964.20
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cofinity Commercial |
$1,388.45
|
| Rate for Payer: Cofinity Commercial |
$1,292.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.20
|
| Rate for Payer: Healthscope Commercial |
$1,157.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,157.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,012.41
|
| Rate for Payer: Nomi Health Commercial |
$1,157.04
|
| Rate for Payer: PACE SWMI |
$964.20
|
| Rate for Payer: PHP Medicare Advantage |
$964.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.05
|
| Rate for Payer: Priority Health Medicare |
$964.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.20
|
| Rate for Payer: UHC Medicare Advantage |
$964.20
|
| Rate for Payer: UHCCP DNSP |
$964.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM
|
Professional
|
Both
|
$896.00
|
|
|
Service Code
|
HCPCS 21015
|
| Min. Negotiated Rate |
$358.40 |
| Max. Negotiated Rate |
$964.43 |
| Rate for Payer: Aetna Commercial |
$897.45
|
| Rate for Payer: Aetna Medicare |
$669.74
|
| Rate for Payer: BCBS Complete |
$358.40
|
| Rate for Payer: BCBS MAPPO |
$669.74
|
| Rate for Payer: BCN Medicare Advantage |
$669.74
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cash Price |
$716.80
|
| Rate for Payer: Cofinity Commercial |
$964.43
|
| Rate for Payer: Cofinity Commercial |
$897.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$669.74
|
| Rate for Payer: Healthscope Commercial |
$803.69
|
| Rate for Payer: Healthscope Whirlpool |
$803.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$703.23
|
| Rate for Payer: Nomi Health Commercial |
$803.69
|
| Rate for Payer: PACE SWMI |
$669.74
|
| Rate for Payer: PHP Medicare Advantage |
$669.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.40
|
| Rate for Payer: Priority Health Medicare |
$669.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$669.74
|
| Rate for Payer: UHC Medicare Advantage |
$669.74
|
| Rate for Payer: UHCCP DNSP |
$669.74
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$2,420.00
|
|
|
Service Code
|
HCPCS 22905
|
| Min. Negotiated Rate |
$968.00 |
| Max. Negotiated Rate |
$1,860.48 |
| Rate for Payer: Aetna Commercial |
$1,731.28
|
| Rate for Payer: Aetna Medicare |
$1,292.00
|
| Rate for Payer: BCBS Complete |
$968.00
|
| Rate for Payer: BCBS MAPPO |
$1,292.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,292.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cash Price |
$1,936.00
|
| Rate for Payer: Cofinity Commercial |
$1,860.48
|
| Rate for Payer: Cofinity Commercial |
$1,731.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,292.00
|
| Rate for Payer: Healthscope Commercial |
$1,550.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,550.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,356.60
|
| Rate for Payer: Nomi Health Commercial |
$1,550.40
|
| Rate for Payer: PACE SWMI |
$1,292.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,292.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,573.00
|
| Rate for Payer: Priority Health Medicare |
$1,292.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,292.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,292.00
|
| Rate for Payer: UHCCP DNSP |
$1,292.00
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM
|
Professional
|
Both
|
$2,134.00
|
|
|
Service Code
|
HCPCS 22904
|
| Min. Negotiated Rate |
$853.60 |
| Max. Negotiated Rate |
$1,454.69 |
| Rate for Payer: Aetna Commercial |
$1,353.67
|
| Rate for Payer: Aetna Medicare |
$1,010.20
|
| Rate for Payer: BCBS Complete |
$853.60
|
| Rate for Payer: BCBS MAPPO |
$1,010.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,010.20
|
| Rate for Payer: Cash Price |
$1,707.20
|
| Rate for Payer: Cash Price |
$1,707.20
|
| Rate for Payer: Cofinity Commercial |
$1,454.69
|
| Rate for Payer: Cofinity Commercial |
$1,353.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,010.20
|
| Rate for Payer: Healthscope Commercial |
$1,212.24
|
| Rate for Payer: Healthscope Whirlpool |
$1,212.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,060.71
|
| Rate for Payer: Nomi Health Commercial |
$1,212.24
|
| Rate for Payer: PACE SWMI |
$1,010.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,010.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,387.10
|
| Rate for Payer: Priority Health Medicare |
$1,010.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,010.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,010.20
|
| Rate for Payer: UHCCP DNSP |
$1,010.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM
|
Professional
|
Both
|
$2,940.00
|
|
|
Service Code
|
HCPCS 21935
|
| Min. Negotiated Rate |
$984.68 |
| Max. Negotiated Rate |
$1,911.00 |
| Rate for Payer: Aetna Commercial |
$1,319.47
|
| Rate for Payer: Aetna Medicare |
$984.68
|
| Rate for Payer: BCBS Complete |
$1,176.00
|
| Rate for Payer: BCBS MAPPO |
$984.68
|
| Rate for Payer: BCN Medicare Advantage |
$984.68
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cash Price |
$2,352.00
|
| Rate for Payer: Cofinity Commercial |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,319.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.68
|
| Rate for Payer: Healthscope Commercial |
$1,181.62
|
| Rate for Payer: Healthscope Whirlpool |
$1,181.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,033.91
|
| Rate for Payer: Nomi Health Commercial |
$1,181.62
|
| Rate for Payer: PACE SWMI |
$984.68
|
| Rate for Payer: PHP Medicare Advantage |
$984.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,911.00
|
| Rate for Payer: Priority Health Medicare |
$984.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.68
|
| Rate for Payer: UHC Medicare Advantage |
$984.68
|
| Rate for Payer: UHCCP DNSP |
$984.68
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>
|
Professional
|
Both
|
$2,598.00
|
|
|
Service Code
|
HCPCS 21936
|
| Min. Negotiated Rate |
$1,039.20 |
| Max. Negotiated Rate |
$1,969.53 |
| Rate for Payer: Aetna Commercial |
$1,832.76
|
| Rate for Payer: Aetna Medicare |
$1,367.73
|
| Rate for Payer: BCBS Complete |
$1,039.20
|
| Rate for Payer: BCBS MAPPO |
$1,367.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,367.73
|
| Rate for Payer: Cash Price |
$2,078.40
|
| Rate for Payer: Cash Price |
$2,078.40
|
| Rate for Payer: Cofinity Commercial |
$1,969.53
|
| Rate for Payer: Cofinity Commercial |
$1,832.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,367.73
|
| Rate for Payer: Healthscope Commercial |
$1,641.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,641.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,436.12
|
| Rate for Payer: Nomi Health Commercial |
$1,641.28
|
| Rate for Payer: PACE SWMI |
$1,367.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,367.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,688.70
|
| Rate for Payer: Priority Health Medicare |
$1,367.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,367.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,367.73
|
| Rate for Payer: UHCCP DNSP |
$1,367.73
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>
|
Professional
|
Both
|
$2,313.00
|
|
|
Service Code
|
HCPCS 27616
|
| Min. Negotiated Rate |
$925.20 |
| Max. Negotiated Rate |
$1,734.42 |
| Rate for Payer: Aetna Commercial |
$1,613.98
|
| Rate for Payer: Aetna Medicare |
$1,204.46
|
| Rate for Payer: BCBS Complete |
$925.20
|
| Rate for Payer: BCBS MAPPO |
$1,204.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,204.46
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cash Price |
$1,850.40
|
| Rate for Payer: Cofinity Commercial |
$1,734.42
|
| Rate for Payer: Cofinity Commercial |
$1,613.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,204.46
|
| Rate for Payer: Healthscope Commercial |
$1,445.35
|
| Rate for Payer: Healthscope Whirlpool |
$1,445.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,264.68
|
| Rate for Payer: Nomi Health Commercial |
$1,445.35
|
| Rate for Payer: PACE SWMI |
$1,204.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,204.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,503.45
|
| Rate for Payer: Priority Health Medicare |
$1,204.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,204.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,204.46
|
| Rate for Payer: UHCCP DNSP |
$1,204.46
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM
|
Professional
|
Both
|
$2,051.00
|
|
|
Service Code
|
HCPCS 23077
|
| Min. Negotiated Rate |
$820.40 |
| Max. Negotiated Rate |
$1,577.92 |
| Rate for Payer: Aetna Commercial |
$1,468.35
|
| Rate for Payer: Aetna Medicare |
$1,095.78
|
| Rate for Payer: BCBS Complete |
$820.40
|
| Rate for Payer: BCBS MAPPO |
$1,095.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,095.78
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cash Price |
$1,640.80
|
| Rate for Payer: Cofinity Commercial |
$1,577.92
|
| Rate for Payer: Cofinity Commercial |
$1,468.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,095.78
|
| Rate for Payer: Healthscope Commercial |
$1,314.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,314.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,150.57
|
| Rate for Payer: Nomi Health Commercial |
$1,314.94
|
| Rate for Payer: PACE SWMI |
$1,095.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,095.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.15
|
| Rate for Payer: Priority Health Medicare |
$1,095.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,095.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.78
|
| Rate for Payer: UHCCP DNSP |
$1,095.78
|
|
|
PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>
|
Professional
|
Both
|
$6,657.00
|
|
|
Service Code
|
HCPCS 27364
|
| Min. Negotiated Rate |
$1,512.06 |
| Max. Negotiated Rate |
$4,327.05 |
| Rate for Payer: Aetna Commercial |
$2,026.16
|
| Rate for Payer: Aetna Medicare |
$1,512.06
|
| Rate for Payer: BCBS Complete |
$2,662.80
|
| Rate for Payer: BCBS MAPPO |
$1,512.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,512.06
|
| Rate for Payer: Cash Price |
$5,325.60
|
| Rate for Payer: Cash Price |
$5,325.60
|
| Rate for Payer: Cofinity Commercial |
$2,177.37
|
| Rate for Payer: Cofinity Commercial |
$2,026.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,512.06
|
| Rate for Payer: Healthscope Commercial |
$1,814.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,814.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,587.66
|
| Rate for Payer: Nomi Health Commercial |
$1,814.47
|
| Rate for Payer: PACE SWMI |
$1,512.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,512.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,327.05
|
| Rate for Payer: Priority Health Medicare |
$1,512.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,512.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,512.06
|
| Rate for Payer: UHCCP DNSP |
$1,512.06
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
OP
|
$2,876.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$4,326.52 |
| Rate for Payer: Aetna Commercial |
$2,588.40
|
| 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 |
$2,789.72
|
| Rate for Payer: ASR Commercial |
$2,789.72
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,355.16
|
| Rate for Payer: BCN Commercial |
$2,229.76
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$2,703.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,300.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,876.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,789.72
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,791.30
|
| Rate for Payer: Mclaren Commercial |
$2,588.40
|
| 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 |
$2,444.60
|
| Rate for Payer: Nomi Health Commercial |
$2,358.32
|
| 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 |
$1,869.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,519.95
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health Narrow Network |
$2,016.08
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,530.88
|
| 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 RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$835.39 |
| Max. Negotiated Rate |
$1,869.40 |
| Rate for Payer: Aetna Commercial |
$1,119.42
|
| Rate for Payer: Aetna Medicare |
$835.39
|
| Rate for Payer: BCBS Complete |
$1,150.40
|
| Rate for Payer: BCBS MAPPO |
$835.39
|
| Rate for Payer: BCN Medicare Advantage |
$835.39
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,202.96
|
| Rate for Payer: Cofinity Commercial |
$1,119.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.39
|
| Rate for Payer: Healthscope Commercial |
$1,002.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.16
|
| Rate for Payer: Nomi Health Commercial |
$1,002.47
|
| Rate for Payer: PACE SWMI |
$835.39
|
| Rate for Payer: PHP Medicare Advantage |
$835.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health Medicare |
$835.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.39
|
| Rate for Payer: UHC Medicare Advantage |
$835.39
|
| Rate for Payer: UHCCP DNSP |
$835.39
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Facility
|
IP
|
$2,876.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
25077
|
| Min. Negotiated Rate |
$1,869.40 |
| Max. Negotiated Rate |
$2,876.00 |
| Rate for Payer: Aetna Commercial |
$2,588.40
|
| Rate for Payer: ASR ASR |
$2,789.72
|
| Rate for Payer: ASR Commercial |
$2,789.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,343.65
|
| Rate for Payer: BCN Commercial |
$2,229.76
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$2,703.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,300.80
|
| Rate for Payer: Healthscope Commercial |
$2,876.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,789.72
|
| Rate for Payer: Mclaren Commercial |
$2,588.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,444.60
|
| Rate for Payer: Nomi Health Commercial |
$2,358.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,530.88
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 25077
|
| Min. Negotiated Rate |
$835.39 |
| Max. Negotiated Rate |
$1,869.40 |
| Rate for Payer: Aetna Commercial |
$1,119.42
|
| Rate for Payer: Aetna Medicare |
$835.39
|
| Rate for Payer: BCBS Complete |
$1,150.40
|
| Rate for Payer: BCBS MAPPO |
$835.39
|
| Rate for Payer: BCN Medicare Advantage |
$835.39
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,202.96
|
| Rate for Payer: Cofinity Commercial |
$1,119.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.39
|
| Rate for Payer: Healthscope Commercial |
$1,002.47
|
| Rate for Payer: Healthscope Whirlpool |
$1,002.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$877.16
|
| Rate for Payer: Nomi Health Commercial |
$1,002.47
|
| Rate for Payer: PACE SWMI |
$835.39
|
| Rate for Payer: PHP Medicare Advantage |
$835.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,869.40
|
| Rate for Payer: Priority Health Medicare |
$835.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.39
|
| Rate for Payer: UHC Medicare Advantage |
$835.39
|
| Rate for Payer: UHCCP DNSP |
$835.39
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM
|
Professional
|
Both
|
$1,677.00
|
|
|
Service Code
|
HCPCS 21557
|
| Min. Negotiated Rate |
$670.80 |
| Max. Negotiated Rate |
$1,323.00 |
| Rate for Payer: Aetna Commercial |
$1,231.12
|
| Rate for Payer: Aetna Medicare |
$918.75
|
| Rate for Payer: BCBS Complete |
$670.80
|
| Rate for Payer: BCBS MAPPO |
$918.75
|
| Rate for Payer: BCN Medicare Advantage |
$918.75
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cash Price |
$1,341.60
|
| Rate for Payer: Cofinity Commercial |
$1,323.00
|
| Rate for Payer: Cofinity Commercial |
$1,231.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.75
|
| Rate for Payer: Healthscope Commercial |
$1,102.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,102.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.69
|
| Rate for Payer: Nomi Health Commercial |
$1,102.50
|
| Rate for Payer: PACE SWMI |
$918.75
|
| Rate for Payer: PHP Medicare Advantage |
$918.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.05
|
| Rate for Payer: Priority Health Medicare |
$918.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.75
|
| Rate for Payer: UHC Medicare Advantage |
$918.75
|
| Rate for Payer: UHCCP DNSP |
$918.75
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>
|
Professional
|
Both
|
$3,418.00
|
|
|
Service Code
|
HCPCS 21558
|
| Min. Negotiated Rate |
$1,292.74 |
| Max. Negotiated Rate |
$2,221.70 |
| Rate for Payer: Aetna Commercial |
$1,732.27
|
| Rate for Payer: Aetna Medicare |
$1,292.74
|
| Rate for Payer: BCBS Complete |
$1,367.20
|
| Rate for Payer: BCBS MAPPO |
$1,292.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,292.74
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cash Price |
$2,734.40
|
| Rate for Payer: Cofinity Commercial |
$1,861.55
|
| Rate for Payer: Cofinity Commercial |
$1,732.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,292.74
|
| Rate for Payer: Healthscope Commercial |
$1,551.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,551.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,357.38
|
| Rate for Payer: Nomi Health Commercial |
$1,551.29
|
| Rate for Payer: PACE SWMI |
$1,292.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,292.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,221.70
|
| Rate for Payer: Priority Health Medicare |
$1,292.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,292.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,292.74
|
| Rate for Payer: UHCCP DNSP |
$1,292.74
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM
|
Professional
|
Both
|
$2,361.00
|
|
|
Service Code
|
HCPCS 26117
|
| Min. Negotiated Rate |
$721.43 |
| Max. Negotiated Rate |
$1,534.65 |
| Rate for Payer: Aetna Commercial |
$966.72
|
| Rate for Payer: Aetna Medicare |
$721.43
|
| Rate for Payer: BCBS Complete |
$944.40
|
| Rate for Payer: BCBS MAPPO |
$721.43
|
| Rate for Payer: BCN Medicare Advantage |
$721.43
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$966.72
|
| Rate for Payer: Cofinity Commercial |
$1,038.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$721.43
|
| Rate for Payer: Healthscope Commercial |
$865.72
|
| Rate for Payer: Healthscope Whirlpool |
$865.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$757.50
|
| Rate for Payer: Nomi Health Commercial |
$865.72
|
| Rate for Payer: PACE SWMI |
$721.43
|
| Rate for Payer: PHP Medicare Advantage |
$721.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.65
|
| Rate for Payer: Priority Health Medicare |
$721.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$721.43
|
| Rate for Payer: UHC Medicare Advantage |
$721.43
|
| Rate for Payer: UHCCP DNSP |
$721.43
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 27049
|
| Min. Negotiated Rate |
$1,264.80 |
| Max. Negotiated Rate |
$2,055.30 |
| Rate for Payer: Aetna Commercial |
$1,839.71
|
| Rate for Payer: Aetna Medicare |
$1,372.92
|
| Rate for Payer: BCBS Complete |
$1,264.80
|
| Rate for Payer: BCBS MAPPO |
$1,372.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,372.92
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Cofinity Commercial |
$1,977.00
|
| Rate for Payer: Cofinity Commercial |
$1,839.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,372.92
|
| Rate for Payer: Healthscope Commercial |
$1,647.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,647.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,441.57
|
| Rate for Payer: Nomi Health Commercial |
$1,647.50
|
| Rate for Payer: PACE SWMI |
$1,372.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,372.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
| Rate for Payer: Priority Health Medicare |
$1,372.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,372.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,372.92
|
| Rate for Payer: UHCCP DNSP |
$1,372.92
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM
|
Professional
|
Both
|
$3,378.00
|
|
|
Service Code
|
HCPCS 27329
|
| Min. Negotiated Rate |
$1,006.86 |
| Max. Negotiated Rate |
$2,195.70 |
| Rate for Payer: Aetna Commercial |
$1,349.19
|
| Rate for Payer: Aetna Medicare |
$1,006.86
|
| Rate for Payer: BCBS Complete |
$1,351.20
|
| Rate for Payer: BCBS MAPPO |
$1,006.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.86
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cash Price |
$2,702.40
|
| Rate for Payer: Cofinity Commercial |
$1,449.88
|
| Rate for Payer: Cofinity Commercial |
$1,349.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.86
|
| Rate for Payer: Healthscope Commercial |
$1,208.23
|
| Rate for Payer: Healthscope Whirlpool |
$1,208.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,057.20
|
| Rate for Payer: Nomi Health Commercial |
$1,208.23
|
| Rate for Payer: PACE SWMI |
$1,006.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.70
|
| Rate for Payer: Priority Health Medicare |
$1,006.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,006.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,006.86
|
| Rate for Payer: UHCCP DNSP |
$1,006.86
|
|
|
PR RAPID DESENSITIZATION PROCEDURE EACH HOUR
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 95180
|
| Min. Negotiated Rate |
$96.26 |
| Max. Negotiated Rate |
$164.45 |
| Rate for Payer: Aetna Commercial |
$128.99
|
| Rate for Payer: Aetna Medicare |
$96.26
|
| Rate for Payer: BCBS Complete |
$101.20
|
| Rate for Payer: BCBS MAPPO |
$96.26
|
| Rate for Payer: BCN Medicare Advantage |
$96.26
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$138.61
|
| Rate for Payer: Cofinity Commercial |
$128.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.26
|
| Rate for Payer: Healthscope Commercial |
$115.51
|
| Rate for Payer: Healthscope Whirlpool |
$115.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.07
|
| Rate for Payer: Nomi Health Commercial |
$115.51
|
| Rate for Payer: PACE SWMI |
$96.26
|
| Rate for Payer: PHP Medicare Advantage |
$96.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.45
|
| Rate for Payer: Priority Health Medicare |
$96.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.26
|
| Rate for Payer: UHC Medicare Advantage |
$96.26
|
| Rate for Payer: UHCCP DNSP |
$96.26
|
|
|
PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 28313
|
| Hospital Charge Code |
28313
|
| Min. Negotiated Rate |
$340.40 |
| Max. Negotiated Rate |
$553.15 |
| Rate for Payer: Aetna Commercial |
$467.98
|
| Rate for Payer: Aetna Medicare |
$349.24
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$349.24
|
| Rate for Payer: BCN Medicare Advantage |
$349.24
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$502.91
|
| Rate for Payer: Cofinity Commercial |
$467.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.24
|
| Rate for Payer: Healthscope Commercial |
$419.09
|
| Rate for Payer: Healthscope Whirlpool |
$419.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.70
|
| Rate for Payer: Nomi Health Commercial |
$419.09
|
| Rate for Payer: PACE SWMI |
$349.24
|
| Rate for Payer: PHP Medicare Advantage |
$349.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.15
|
| Rate for Payer: Priority Health Medicare |
$349.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.24
|
| Rate for Payer: UHC Medicare Advantage |
$349.24
|
| Rate for Payer: UHCCP DNSP |
$349.24
|
|
