|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA OVER 4.0 CM
|
Facility
|
IP
|
$1,904.19
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
76100100
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,199.64 |
| Max. Negotiated Rate |
$1,713.77 |
| Rate for Payer: Aetna Commercial |
$1,618.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.72
|
| Rate for Payer: Cash Price |
$1,523.35
|
| Rate for Payer: Cofinity Commercial |
$1,332.93
|
| Rate for Payer: Cofinity Commercial |
$1,637.60
|
| Rate for Payer: Healthscope Commercial |
$1,713.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.56
|
| Rate for Payer: PHP Commercial |
$1,618.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.93
|
| Rate for Payer: Priority Health SBD |
$1,199.64
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$822.28
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$518.04 |
| Max. Negotiated Rate |
$740.05 |
| Rate for Payer: Aetna Commercial |
$698.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.48
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cofinity Commercial |
$575.60
|
| Rate for Payer: Cofinity Commercial |
$707.16
|
| Rate for Payer: Healthscope Commercial |
$740.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$698.94
|
| Rate for Payer: PHP Commercial |
$698.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.60
|
| Rate for Payer: Priority Health SBD |
$518.04
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$822.28
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
76100089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$698.94
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.55
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$626.04
|
| Rate for Payer: BCBS Trust/PPO |
$405.67
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cash Price |
$657.82
|
| Rate for Payer: Cofinity Commercial |
$575.60
|
| Rate for Payer: Cofinity Commercial |
$707.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$740.05
|
| Rate for Payer: Mclaren Medicaid |
$342.44
|
| Rate for Payer: Mclaren Medicare |
$626.04
|
| Rate for Payer: Meridian Medicaid |
$359.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$698.94
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$698.94
|
| Rate for Payer: PHP Medicare Advantage |
$626.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,937.58
|
| Rate for Payer: Priority Health Medicare |
$626.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.06
|
| Rate for Payer: Priority Health SBD |
$518.04
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$83.50
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.45 |
| Max. Negotiated Rate |
$1,076.20 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$368.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.50
|
| Rate for Payer: BCBS Complete |
$203.80
|
| Rate for Payer: BCBS MAPPO |
$354.80
|
| Rate for Payer: BCBS Trust/PPO |
$233.21
|
| Rate for Payer: BCN Medicare Advantage |
$354.80
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Cofinity Commercial |
$411.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.80
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Mclaren Medicaid |
$194.08
|
| Rate for Payer: Mclaren Medicare |
$354.80
|
| Rate for Payer: Meridian Medicaid |
$203.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Medicare |
$337.06
|
| Rate for Payer: PACE SWMI |
$354.80
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$354.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.20
|
| Rate for Payer: Priority Health Medicare |
$354.80
|
| Rate for Payer: Priority Health Narrow Network |
$860.96
|
| Rate for Payer: Priority Health SBD |
$370.64
|
| Rate for Payer: Railroad Medicare Medicare |
$354.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.80
|
| Rate for Payer: UHC Exchange |
$104.45
|
| Rate for Payer: UHC Medicare Advantage |
$365.44
|
| Rate for Payer: VA VA |
$354.80
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$370.64 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.40
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$411.82
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health SBD |
$370.64
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,268.88
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.28 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$1,078.55
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.55
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$626.04
|
| Rate for Payer: BCBS Trust/PPO |
$405.67
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cofinity Commercial |
$1,091.24
|
| Rate for Payer: Cofinity Commercial |
$888.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$1,141.99
|
| Rate for Payer: Mclaren Medicaid |
$342.44
|
| Rate for Payer: Mclaren Medicare |
$626.04
|
| Rate for Payer: Meridian Medicaid |
$359.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,078.55
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$1,078.55
|
| Rate for Payer: PHP Medicare Advantage |
$626.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,937.58
|
| Rate for Payer: Priority Health Medicare |
$626.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.06
|
| Rate for Payer: Priority Health SBD |
$799.39
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$114.28
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,268.88
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$799.39 |
| Max. Negotiated Rate |
$1,141.99 |
| Rate for Payer: Aetna Commercial |
$1,078.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.77
|
| Rate for Payer: Cash Price |
$1,015.10
|
| Rate for Payer: Cofinity Commercial |
$1,091.24
|
| Rate for Payer: Cofinity Commercial |
$888.22
|
| Rate for Payer: Healthscope Commercial |
$1,141.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,078.55
|
| Rate for Payer: PHP Commercial |
$1,078.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.22
|
| Rate for Payer: Priority Health SBD |
$799.39
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$148.00 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.55
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$626.04
|
| Rate for Payer: BCBS Trust/PPO |
$405.67
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$342.44
|
| Rate for Payer: Mclaren Medicare |
$626.04
|
| Rate for Payer: Meridian Medicaid |
$359.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$626.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,937.58
|
| Rate for Payer: Priority Health Medicare |
$626.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.06
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$148.00
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$726.38 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,383.59
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.74 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$1,176.05
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$962.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cofinity Commercial |
$968.51
|
| Rate for Payer: Cofinity Commercial |
$1,189.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,245.23
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,176.05
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,176.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$871.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$162.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,383.59
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$871.66 |
| Max. Negotiated Rate |
$1,245.23 |
| Rate for Payer: Aetna Commercial |
$1,176.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$899.33
|
| Rate for Payer: Cash Price |
$1,106.87
|
| Rate for Payer: Cofinity Commercial |
$1,189.89
|
| Rate for Payer: Cofinity Commercial |
$968.51
|
| Rate for Payer: Healthscope Commercial |
$1,245.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,176.05
|
| Rate for Payer: PHP Commercial |
$1,176.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$968.51
|
| Rate for Payer: Priority Health SBD |
$871.66
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,077.30
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$245.25 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Commercial |
$1,765.70
|
| Rate for Payer: Aetna Medicare |
$1,500.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,350.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,803.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,803.26
|
| Rate for Payer: BCBS Complete |
$828.64
|
| Rate for Payer: BCBS MAPPO |
$1,442.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,394.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,442.61
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cofinity Commercial |
$1,786.48
|
| Rate for Payer: Cofinity Commercial |
$1,454.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,442.61
|
| Rate for Payer: Healthscope Commercial |
$1,869.57
|
| Rate for Payer: Mclaren Medicaid |
$789.11
|
| Rate for Payer: Mclaren Medicare |
$1,442.61
|
| Rate for Payer: Meridian Medicaid |
$828.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,514.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,765.70
|
| Rate for Payer: PACE Medicare |
$1,370.48
|
| Rate for Payer: PACE SWMI |
$1,442.61
|
| Rate for Payer: PHP Commercial |
$1,765.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,442.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$789.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,442.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,308.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,442.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,442.61
|
| Rate for Payer: UHC Exchange |
$245.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,485.89
|
| Rate for Payer: VA VA |
$1,442.61
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,077.30
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,308.70 |
| Max. Negotiated Rate |
$1,869.57 |
| Rate for Payer: Aetna Commercial |
$1,765.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,350.24
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cofinity Commercial |
$1,454.11
|
| Rate for Payer: Cofinity Commercial |
$1,786.48
|
| Rate for Payer: Healthscope Commercial |
$1,869.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,765.70
|
| Rate for Payer: PHP Commercial |
$1,765.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.11
|
| Rate for Payer: Priority Health SBD |
$1,308.70
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,635.22
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,920.19 |
| Max. Negotiated Rate |
$4,171.70 |
| Rate for Payer: Aetna Commercial |
$3,939.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,012.89
|
| Rate for Payer: Cash Price |
$3,708.18
|
| Rate for Payer: Cofinity Commercial |
$3,244.65
|
| Rate for Payer: Cofinity Commercial |
$3,986.29
|
| Rate for Payer: Healthscope Commercial |
$4,171.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,939.94
|
| Rate for Payer: PHP Commercial |
$3,939.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,244.65
|
| Rate for Payer: Priority Health SBD |
$2,920.19
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,635.22
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$414.54 |
| Max. Negotiated Rate |
$10,308.37 |
| Rate for Payer: Aetna Commercial |
$3,939.94
|
| Rate for Payer: Aetna Medicare |
$3,527.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,012.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,239.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,239.58
|
| Rate for Payer: BCBS Complete |
$1,948.17
|
| Rate for Payer: BCBS MAPPO |
$3,391.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,553.65
|
| Rate for Payer: BCCCP Commercial |
$559.44
|
| Rate for Payer: BCN Medicare Advantage |
$3,391.66
|
| Rate for Payer: Cash Price |
$3,708.18
|
| Rate for Payer: Cash Price |
$3,708.18
|
| Rate for Payer: Cofinity Commercial |
$3,986.29
|
| Rate for Payer: Cofinity Commercial |
$3,244.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,391.66
|
| Rate for Payer: Healthscope Commercial |
$4,171.70
|
| Rate for Payer: Mclaren Medicaid |
$1,855.24
|
| Rate for Payer: Mclaren Medicare |
$3,391.66
|
| Rate for Payer: Meridian Medicaid |
$1,948.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,561.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,900.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,939.94
|
| Rate for Payer: PACE Medicare |
$3,222.08
|
| Rate for Payer: PACE SWMI |
$3,391.66
|
| Rate for Payer: PHP Commercial |
$3,939.94
|
| Rate for Payer: PHP Medicare Advantage |
$3,391.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,855.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,244.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,308.37
|
| Rate for Payer: Priority Health Medicare |
$3,391.66
|
| Rate for Payer: Priority Health Narrow Network |
$8,246.70
|
| Rate for Payer: Priority Health SBD |
$2,920.19
|
| Rate for Payer: Railroad Medicare Medicare |
$3,391.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,391.66
|
| Rate for Payer: UHC Exchange |
$414.54
|
| Rate for Payer: UHC Medicare Advantage |
$3,493.41
|
| Rate for Payer: VA VA |
$3,391.66
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$852.77
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$537.25 |
| Max. Negotiated Rate |
$767.49 |
| Rate for Payer: Aetna Commercial |
$724.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.30
|
| Rate for Payer: Cash Price |
$682.22
|
| Rate for Payer: Cofinity Commercial |
$733.38
|
| Rate for Payer: Cofinity Commercial |
$596.94
|
| Rate for Payer: Healthscope Commercial |
$767.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$724.85
|
| Rate for Payer: PHP Commercial |
$724.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.94
|
| Rate for Payer: Priority Health SBD |
$537.25
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$852.77
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.84 |
| Max. Negotiated Rate |
$2,616.65 |
| Rate for Payer: Aetna Commercial |
$724.85
|
| Rate for Payer: Aetna Medicare |
$936.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,126.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,126.08
|
| Rate for Payer: BCBS Complete |
$517.45
|
| Rate for Payer: BCBS MAPPO |
$900.86
|
| Rate for Payer: BCBS Trust/PPO |
$145.84
|
| Rate for Payer: BCN Medicare Advantage |
$900.86
|
| Rate for Payer: Cash Price |
$682.22
|
| Rate for Payer: Cash Price |
$682.22
|
| Rate for Payer: Cofinity Commercial |
$596.94
|
| Rate for Payer: Cofinity Commercial |
$733.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.86
|
| Rate for Payer: Healthscope Commercial |
$767.49
|
| Rate for Payer: Mclaren Medicaid |
$492.77
|
| Rate for Payer: Mclaren Medicare |
$900.86
|
| Rate for Payer: Meridian Medicaid |
$517.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$945.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,035.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$724.85
|
| Rate for Payer: PACE Medicare |
$855.82
|
| Rate for Payer: PACE SWMI |
$900.86
|
| Rate for Payer: PHP Commercial |
$724.85
|
| Rate for Payer: PHP Medicare Advantage |
$900.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,616.65
|
| Rate for Payer: Priority Health Medicare |
$900.86
|
| Rate for Payer: Priority Health Narrow Network |
$2,093.32
|
| Rate for Payer: Priority Health SBD |
$537.25
|
| Rate for Payer: Railroad Medicare Medicare |
$900.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$900.86
|
| Rate for Payer: UHC Exchange |
$152.92
|
| Rate for Payer: UHC Medicare Advantage |
$927.89
|
| Rate for Payer: VA VA |
$900.86
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$278.98 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,979.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,580.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,580.99
|
| Rate for Payer: BCBS Complete |
$1,645.54
|
| Rate for Payer: BCBS MAPPO |
$2,864.79
|
| Rate for Payer: BCBS Trust/PPO |
$816.32
|
| Rate for Payer: BCN Medicare Advantage |
$2,864.79
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,864.79
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,567.04
|
| Rate for Payer: Mclaren Medicare |
$2,864.79
|
| Rate for Payer: Meridian Medicaid |
$1,645.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,008.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,294.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,721.55
|
| Rate for Payer: PACE SWMI |
$2,864.79
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,864.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,567.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health Medicare |
$2,864.79
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,864.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,864.79
|
| Rate for Payer: UHC Exchange |
$278.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,950.73
|
| Rate for Payer: VA VA |
$2,864.79
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,977.00 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.44 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,979.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,580.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,580.99
|
| Rate for Payer: BCBS Complete |
$1,645.54
|
| Rate for Payer: BCBS MAPPO |
$2,864.79
|
| Rate for Payer: BCBS Trust/PPO |
$116.44
|
| Rate for Payer: BCN Medicare Advantage |
$2,864.79
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,864.79
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Mclaren Medicaid |
$1,567.04
|
| Rate for Payer: Mclaren Medicare |
$2,864.79
|
| Rate for Payer: Meridian Medicaid |
$1,645.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,008.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,294.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,721.55
|
| Rate for Payer: PACE SWMI |
$2,864.79
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,864.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,567.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health Medicare |
$2,864.79
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,864.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,864.79
|
| Rate for Payer: UHC Exchange |
$121.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,950.73
|
| Rate for Payer: VA VA |
$2,864.79
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,977.00 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$3,886.79
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.79 |
| Max. Negotiated Rate |
$3,498.11 |
| Rate for Payer: Aetna Commercial |
$3,303.77
|
| Rate for Payer: Aetna Medicare |
$1,411.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,526.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,696.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,696.21
|
| Rate for Payer: BCBS Complete |
$779.44
|
| Rate for Payer: BCBS MAPPO |
$1,356.97
|
| Rate for Payer: BCBS Trust/PPO |
$764.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,356.97
|
| Rate for Payer: Cash Price |
$3,109.43
|
| Rate for Payer: Cash Price |
$3,109.43
|
| Rate for Payer: Cofinity Commercial |
$3,342.64
|
| Rate for Payer: Cofinity Commercial |
$2,720.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,356.97
|
| Rate for Payer: Healthscope Commercial |
$3,498.11
|
| Rate for Payer: Mclaren Medicaid |
$742.26
|
| Rate for Payer: Mclaren Medicare |
$1,356.97
|
| Rate for Payer: Meridian Medicaid |
$779.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,424.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,560.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,303.77
|
| Rate for Payer: PACE Medicare |
$1,289.12
|
| Rate for Payer: PACE SWMI |
$1,356.97
|
| Rate for Payer: PHP Commercial |
$3,303.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,356.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.75
|
| Rate for Payer: Priority Health Medicare |
$1,356.97
|
| Rate for Payer: Priority Health SBD |
$2,448.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,356.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,356.97
|
| Rate for Payer: UHC Exchange |
$196.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,397.68
|
| Rate for Payer: VA VA |
$1,356.97
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
IP
|
$3,886.79
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,448.68 |
| Max. Negotiated Rate |
$3,498.11 |
| Rate for Payer: Aetna Commercial |
$3,303.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,526.41
|
| Rate for Payer: Cash Price |
$3,109.43
|
| Rate for Payer: Cofinity Commercial |
$2,720.75
|
| Rate for Payer: Cofinity Commercial |
$3,342.64
|
| Rate for Payer: Healthscope Commercial |
$3,498.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,303.77
|
| Rate for Payer: PHP Commercial |
$3,303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.75
|
| Rate for Payer: Priority Health SBD |
$2,448.68
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$726.38 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.78 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.55
|
| Rate for Payer: BCBS Complete |
$359.60
|
| Rate for Payer: BCBS MAPPO |
$626.04
|
| Rate for Payer: BCBS Trust/PPO |
$99.78
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Mclaren Medicaid |
$342.44
|
| Rate for Payer: Mclaren Medicare |
$626.04
|
| Rate for Payer: Meridian Medicaid |
$359.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$657.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$626.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,937.58
|
| Rate for Payer: Priority Health Medicare |
$626.04
|
| Rate for Payer: Priority Health Narrow Network |
$1,550.06
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$124.76
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
