|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.74 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.40
|
| 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 |
$112.74
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| 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 |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| 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 |
$500.06
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$500.06
|
| 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 |
$411.82
|
| 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 |
$370.64
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$152.59
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
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 MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$178.46 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.40
|
| 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 |
$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 |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| 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 |
$500.06
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$500.06
|
| 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 |
$411.82
|
| 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 |
$370.64
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$178.46
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
IP
|
$185.64
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.95 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.79
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health SBD |
$116.95
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
OP
|
$185.64
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.28 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.67
|
| 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 |
$95.28
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$129.95
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| 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 |
$157.79
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$157.79
|
| 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 |
$129.95
|
| 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 |
$116.95
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$120.50
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.04 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.40
|
| 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 |
$109.04
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| 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 |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| 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 |
$500.06
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$500.06
|
| 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 |
$411.82
|
| 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 |
$370.64
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$145.71
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.15 |
| 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 |
$315.91
|
| 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) |
$173.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.80
|
| Rate for Payer: UHC Exchange |
$158.15
|
| Rate for Payer: UHC Medicare Advantage |
$365.44
|
| Rate for Payer: VA VA |
$354.80
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
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 TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$188.93 |
| 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 |
$991.57
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| 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) |
$207.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$188.93
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$306.31
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$1,937.58 |
| Rate for Payer: Aetna Commercial |
$260.36
|
| Rate for Payer: Aetna Medicare |
$651.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.10
|
| 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 |
$642.39
|
| Rate for Payer: BCN Medicare Advantage |
$626.04
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cofinity Commercial |
$214.42
|
| Rate for Payer: Cofinity Commercial |
$263.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$626.04
|
| Rate for Payer: Healthscope Commercial |
$275.68
|
| 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 |
$260.36
|
| Rate for Payer: PACE Medicare |
$594.74
|
| Rate for Payer: PACE SWMI |
$626.04
|
| Rate for Payer: PHP Commercial |
$260.36
|
| 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 |
$214.42
|
| 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 |
$192.98
|
| Rate for Payer: Railroad Medicare Medicare |
$626.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$626.04
|
| Rate for Payer: UHC Exchange |
$207.93
|
| Rate for Payer: UHC Medicare Advantage |
$644.82
|
| Rate for Payer: VA VA |
$626.04
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$306.31
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$275.68 |
| Rate for Payer: Aetna Commercial |
$260.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.10
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cofinity Commercial |
$214.42
|
| Rate for Payer: Cofinity Commercial |
$263.43
|
| Rate for Payer: Healthscope Commercial |
$275.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.36
|
| Rate for Payer: PHP Commercial |
$260.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.42
|
| Rate for Payer: Priority Health SBD |
$192.98
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.70 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna Medicare |
$2,979.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,175.95
|
| 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 |
$952.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,864.79
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$5,574.10
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,864.79
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| 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 |
$6,768.55
|
| Rate for Payer: PACE Medicare |
$2,721.55
|
| Rate for Payer: PACE SWMI |
$2,864.79
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| 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 |
$5,574.10
|
| Rate for Payer: Priority Health Medicare |
$2,864.79
|
| Rate for Payer: Priority Health SBD |
$5,016.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,864.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,864.79
|
| Rate for Payer: UHC Exchange |
$164.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,950.73
|
| Rate for Payer: VA VA |
$2,864.79
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,016.69 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,175.95
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$5,574.10
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health SBD |
$5,016.69
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,039.02
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$728.89 |
| Max. Negotiated Rate |
$7,745.99 |
| Rate for Payer: Aetna Commercial |
$5,983.17
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,575.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$895.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,053.56
|
| Rate for Payer: Cofinity Commercial |
$4,927.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$6,335.12
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,983.17
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$5,983.17
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,927.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,745.99
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health Narrow Network |
$6,196.79
|
| Rate for Payer: Priority Health SBD |
$4,434.58
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$801.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$728.89
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,039.02
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,434.58 |
| Max. Negotiated Rate |
$6,335.12 |
| Rate for Payer: Aetna Commercial |
$5,983.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,575.36
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$4,927.31
|
| Rate for Payer: Cofinity Commercial |
$6,053.56
|
| Rate for Payer: Healthscope Commercial |
$6,335.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,983.17
|
| Rate for Payer: PHP Commercial |
$5,983.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,927.31
|
| Rate for Payer: Priority Health SBD |
$4,434.58
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$7,200.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.50 |
| Max. Negotiated Rate |
$6,480.00 |
| Rate for Payer: Aetna Commercial |
$6,120.00
|
| Rate for Payer: Aetna Medicare |
$2,629.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,680.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,160.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,160.42
|
| Rate for Payer: BCBS Complete |
$1,452.28
|
| Rate for Payer: BCBS MAPPO |
$2,528.34
|
| Rate for Payer: BCBS Trust/PPO |
$895.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,528.34
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cofinity Commercial |
$5,040.00
|
| Rate for Payer: Cofinity Commercial |
$6,192.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$6,480.00
|
| Rate for Payer: Mclaren Medicaid |
$1,383.00
|
| Rate for Payer: Mclaren Medicare |
$2,528.34
|
| Rate for Payer: Meridian Medicaid |
$1,452.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,654.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,907.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,120.00
|
| Rate for Payer: PACE Medicare |
$2,401.92
|
| Rate for Payer: PACE SWMI |
$2,528.34
|
| Rate for Payer: PHP Commercial |
$6,120.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,528.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,040.00
|
| Rate for Payer: Priority Health Medicare |
$2,528.34
|
| Rate for Payer: Priority Health SBD |
$4,536.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,528.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,528.34
|
| Rate for Payer: UHC Exchange |
$324.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,604.19
|
| Rate for Payer: VA VA |
$2,528.34
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$7,200.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,536.00 |
| Max. Negotiated Rate |
$6,480.00 |
| Rate for Payer: Aetna Commercial |
$6,120.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,680.00
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cofinity Commercial |
$5,040.00
|
| Rate for Payer: Cofinity Commercial |
$6,192.00
|
| Rate for Payer: Healthscope Commercial |
$6,480.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,120.00
|
| Rate for Payer: PHP Commercial |
$6,120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,040.00
|
| Rate for Payer: Priority Health SBD |
$4,536.00
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$8,517.99 |
| 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 |
$114.59
|
| 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 |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| 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 HMO/PPO/Tiered Network |
$8,517.99
|
| Rate for Payer: Priority Health Medicare |
$2,864.79
|
| Rate for Payer: Priority Health Narrow Network |
$6,814.39
|
| 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) |
$141.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,864.79
|
| Rate for Payer: UHC Exchange |
$128.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,950.73
|
| Rate for Payer: VA VA |
$2,864.79
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.73 |
| Max. Negotiated Rate |
$4,211.89 |
| Rate for Payer: Aetna Commercial |
$3,315.00
|
| Rate for Payer: Aetna Medicare |
$1,411.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,535.00
|
| 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 |
$867.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,356.97
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cofinity Commercial |
$2,730.00
|
| Rate for Payer: Cofinity Commercial |
$3,354.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,356.97
|
| Rate for Payer: Healthscope Commercial |
$3,510.00
|
| 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 |
$3,315.00
|
| Rate for Payer: PACE Medicare |
$1,289.12
|
| Rate for Payer: PACE SWMI |
$1,356.97
|
| Rate for Payer: PHP Commercial |
$3,315.00
|
| 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 |
$2,730.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,211.89
|
| Rate for Payer: Priority Health Medicare |
$1,356.97
|
| Rate for Payer: Priority Health Narrow Network |
$3,369.51
|
| Rate for Payer: Priority Health SBD |
$2,457.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,356.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,356.97
|
| Rate for Payer: UHC Exchange |
$144.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,397.68
|
| Rate for Payer: VA VA |
$1,356.97
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,457.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna Commercial |
$3,315.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,535.00
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cofinity Commercial |
$2,730.00
|
| Rate for Payer: Cofinity Commercial |
$3,354.00
|
| Rate for Payer: Healthscope Commercial |
$3,510.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,315.00
|
| Rate for Payer: PHP Commercial |
$3,315.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: Priority Health SBD |
$2,457.00
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,380.33
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,649.61 |
| Max. Negotiated Rate |
$6,642.30 |
| Rate for Payer: Aetna Commercial |
$6,273.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,797.21
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cofinity Commercial |
$5,166.23
|
| Rate for Payer: Cofinity Commercial |
$6,347.08
|
| Rate for Payer: Healthscope Commercial |
$6,642.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,273.28
|
| Rate for Payer: PHP Commercial |
$6,273.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,166.23
|
| Rate for Payer: Priority Health SBD |
$4,649.61
|
|
