|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER 0.6 TO 1.0 CM
|
Facility
|
OP
|
$2,281.79
|
|
|
Service Code
|
CPT 11421
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER 1.1 TO 2.0 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 11422
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER 2.1 TO 3.0 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 11423
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; EXCISED DIAMETER OVER 4.0 CM
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 11426
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,882.34
|
| Rate for Payer: BCN Commercial |
$1,882.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,309.90
|
|
|
Service Code
|
CPT 11401
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$307.60
|
| Rate for Payer: BCN Commercial |
$307.60
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 1.1 TO 2.0 CM
|
Facility
|
OP
|
$2,281.79
|
|
|
Service Code
|
CPT 11402
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 2.1 TO 3.0 CM
|
Facility
|
OP
|
$2,281.79
|
|
|
Service Code
|
CPT 11403
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER 3.1 TO 4.0 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 11404
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.55
|
| Rate for Payer: BCN Commercial |
$1,269.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; EXCISED DIAMETER OVER 4.0 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 11406
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,839.91
|
| Rate for Payer: BCN Commercial |
$1,839.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); ABDOMEN, INFRAUMBILICAL PANNICULECTOMY
|
Facility
|
OP
|
$21,396.49
|
|
|
Service Code
|
CPT 15830
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,460.32 |
| Max. Negotiated Rate |
$21,396.49 |
| Rate for Payer: Aetna Medicare |
$6,880.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,270.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,270.36
|
| Rate for Payer: BCBS Complete |
$3,633.67
|
| Rate for Payer: BCBS MAPPO |
$6,616.29
|
| Rate for Payer: BCBS Trust/PPO |
$5,814.57
|
| Rate for Payer: BCN Commercial |
$5,814.57
|
| Rate for Payer: BCN Medicare Advantage |
$6,616.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,616.29
|
| Rate for Payer: Mclaren Medicaid |
$3,460.32
|
| Rate for Payer: Mclaren Medicare |
$6,616.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,947.10
|
| Rate for Payer: Meridian Medicaid |
$6,947.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,608.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,277.92
|
| Rate for Payer: Nomi Health Commercial |
$19,848.87
|
| Rate for Payer: PACE Medicare |
$6,285.48
|
| Rate for Payer: PACE SWMI |
$6,616.29
|
| Rate for Payer: PHP Medicare Advantage |
$6,616.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,460.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21,396.49
|
| Rate for Payer: Priority Health Medicare |
$6,616.29
|
| Rate for Payer: Priority Health Tiered Network |
$17,117.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6,616.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,616.29
|
| Rate for Payer: UHC Medicaid |
$3,460.32
|
| Rate for Payer: UHCCP Medicaid |
$3,460.32
|
| Rate for Payer: VA VA |
$6,616.29
|
|
|
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); OTHER AREA
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 15839
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION INFERIOR TURBINATE, PARTIAL OR COMPLETE, ANY METHOD
|
Facility
|
OP
|
$10,683.35
|
|
|
Service Code
|
CPT 30130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,345.91 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,345.91
|
| Rate for Payer: BCN Commercial |
$1,345.91
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Mclaren Medicaid |
$1,727.75
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 2.1 TO 3.0 CM
|
Facility
|
OP
|
$2,281.79
|
|
|
Service Code
|
CPT 11603
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER OVER 4.0 CM
|
Facility
|
OP
|
$5,321.93
|
|
|
Service Code
|
CPT 11606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,734.87
|
| Rate for Payer: BCN Commercial |
$1,734.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
EXCISION OF BARTHOLIN'S GLAND OR CYST
|
Facility
|
OP
|
$10,430.93
|
|
|
Service Code
|
CPT 56740
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,215.56
|
| Rate for Payer: BCN Commercial |
$2,215.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Mclaren Medicaid |
$1,686.93
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER, OPEN; SINGLE LESION
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 19125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$569.78 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,994.71
|
| Rate for Payer: BCCCP Commercial |
$569.78
|
| Rate for Payer: BCN Commercial |
$1,994.71
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TISSUE, DUCT LESION, NIPPLE OR AREOLAR LESION (EXCEPT 19300), OPEN, MALE OR FEMALE, 1 OR MORE LESIONS
|
Facility
|
OP
|
$12,616.62
|
|
|
Service Code
|
CPT 19120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,876.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,876.69
|
| Rate for Payer: BCBS Complete |
$2,142.62
|
| Rate for Payer: BCBS MAPPO |
$3,901.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,049.25
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$2,049.25
|
| Rate for Payer: BCN Medicare Advantage |
$3,901.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Mclaren Medicaid |
$2,040.41
|
| Rate for Payer: Mclaren Medicare |
$3,901.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,096.42
|
| Rate for Payer: Meridian Medicaid |
$4,096.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,486.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,291.48
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,901.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,040.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,616.62
|
| Rate for Payer: Priority Health Medicare |
$3,901.35
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY
|
Facility
|
OP
|
$5,181.40
|
|
|
Service Code
|
CPT 25111
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.37
|
| Rate for Payer: BCN Commercial |
$1,658.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Mclaren Medicaid |
$837.96
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: VA VA |
$1,602.21
|
|
|
EXCISION OF HYDROCELE; UNILATERAL
|
Facility
|
OP
|
$11,537.07
|
|
|
Service Code
|
CPT 55040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,296.55
|
| Rate for Payer: BCN Commercial |
$2,296.55
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Mclaren Medicaid |
$1,865.82
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: VA VA |
$3,567.53
|
|
|
EXCISION OF LESION OF SPERMATIC CORD (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$11,358.48
|
|
|
Service Code
|
CPT 55520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,352.02 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.02
|
| Rate for Payer: BCN Commercial |
$1,352.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Mclaren Medicaid |
$1,836.94
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: VA VA |
$3,512.31
|
|
|
EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE, WITH DISSECTION AND PRESERVATION OF FACIAL NERVE
|
Facility
|
OP
|
$19,075.37
|
|
|
Service Code
|
CPT 42415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCBS Trust/PPO |
$5,488.42
|
| Rate for Payer: BCN Commercial |
$5,488.42
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Mclaren Medicaid |
$3,084.94
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: VA VA |
$5,898.54
|
|
|
EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 11772
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,305.29
|
| Rate for Payer: BCN Commercial |
$2,305.29
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 11771
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.72
|
| Rate for Payer: BCN Commercial |
$2,458.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE
|
Facility
|
OP
|
$9,359.82
|
|
|
Service Code
|
CPT 11770
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,152.59
|
| Rate for Payer: BCN Commercial |
$2,152.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 45172
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,009.84
|
| Rate for Payer: BCN Commercial |
$2,009.84
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
