|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.61 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health SBD |
$385.61
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$1,122.13
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.10
|
| 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: Cash Price |
$1,056.12
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Advantage |
$924.11
|
| Rate for Payer: Cofinity Commercial |
$1,135.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,188.13
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,122.13
|
| 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 SBD |
$831.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.10
|
| Rate for Payer: UHC Core |
$687.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$518.82
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$831.69 |
| Max. Negotiated Rate |
$1,188.13 |
| Rate for Payer: Aetna Commercial |
$1,122.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$858.10
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Advantage |
$924.11
|
| Rate for Payer: Cofinity Commercial |
$1,135.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Healthscope Commercial |
$1,188.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PHP Commercial |
$1,122.13
|
| Rate for Payer: Priority Health SBD |
$831.69
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| 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: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| 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 SBD |
$755.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.72
|
| Rate for Payer: UHC Core |
$624.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$471.43
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$755.73 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health SBD |
$755.73
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$906.88 |
| Max. Negotiated Rate |
$1,295.54 |
| Rate for Payer: Aetna Commercial |
$1,223.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.67
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Advantage |
$1,007.64
|
| Rate for Payer: Cofinity Commercial |
$1,237.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Healthscope Commercial |
$1,295.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PHP Commercial |
$1,223.57
|
| Rate for Payer: Priority Health SBD |
$906.88
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$565.72 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,223.57
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$935.67
|
| 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: Cash Price |
$1,151.59
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Advantage |
$1,007.64
|
| Rate for Payer: Cofinity Commercial |
$1,237.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,295.54
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,223.57
|
| 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 SBD |
$906.88
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.67
|
| Rate for Payer: UHC Core |
$749.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$565.72
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,361.57 |
| Max. Negotiated Rate |
$1,945.11 |
| Rate for Payer: Aetna Commercial |
$1,837.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.80
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Advantage |
$1,512.86
|
| Rate for Payer: Cofinity Commercial |
$1,858.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Healthscope Commercial |
$1,945.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PHP Commercial |
$1,837.05
|
| Rate for Payer: Priority Health SBD |
$1,361.57
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$849.36 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,837.05
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.80
|
| 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: Cash Price |
$1,728.98
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Advantage |
$1,512.86
|
| Rate for Payer: Cofinity Commercial |
$1,858.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,945.11
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,837.05
|
| 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 SBD |
$1,361.57
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,404.80
|
| Rate for Payer: UHC Core |
$1,126.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$849.36
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,038.16 |
| Max. Negotiated Rate |
$4,340.23 |
| Rate for Payer: Aetna Commercial |
$4,099.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,134.61
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Advantage |
$3,375.74
|
| Rate for Payer: Cofinity Commercial |
$4,147.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Healthscope Commercial |
$4,340.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PHP Commercial |
$4,099.11
|
| Rate for Payer: Priority Health SBD |
$3,038.16
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$12,616.62 |
| Rate for Payer: Aetna Commercial |
$4,099.11
|
| Rate for Payer: Aetna Medicare |
$4,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,134.61
|
| 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: Cash Price |
$3,857.98
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Advantage |
$3,375.74
|
| Rate for Payer: Cofinity Commercial |
$4,147.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,901.35
|
| Rate for Payer: Healthscope Commercial |
$4,340.23
|
| 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: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Nomi Health Commercial |
$11,704.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PACE Medicare |
$3,706.28
|
| Rate for Payer: PACE SWMI |
$3,901.35
|
| Rate for Payer: PHP Commercial |
$4,099.11
|
| 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 SBD |
$3,038.16
|
| Rate for Payer: Priority Health Tiered Network |
$10,093.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,901.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,134.61
|
| Rate for Payer: UHC Core |
$2,512.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,901.35
|
| Rate for Payer: UHC Exchange |
$1,895.23
|
| Rate for Payer: UHC Medicaid |
$2,040.41
|
| Rate for Payer: UHCCP Medicaid |
$2,040.41
|
| Rate for Payer: VA VA |
$3,901.35
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$558.95 |
| Max. Negotiated Rate |
$798.51 |
| Rate for Payer: Aetna Commercial |
$754.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.70
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Advantage |
$621.06
|
| Rate for Payer: Cofinity Commercial |
$763.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Healthscope Commercial |
$798.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PHP Commercial |
$754.15
|
| Rate for Payer: Priority Health SBD |
$558.95
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.36 |
| Max. Negotiated Rate |
$3,212.23 |
| Rate for Payer: Aetna Commercial |
$754.15
|
| Rate for Payer: Aetna Medicare |
$1,033.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,241.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,241.61
|
| Rate for Payer: BCBS Complete |
$545.51
|
| Rate for Payer: BCBS MAPPO |
$993.29
|
| Rate for Payer: BCBS Trust/PPO |
$192.36
|
| Rate for Payer: BCN Commercial |
$192.36
|
| Rate for Payer: BCN Medicare Advantage |
$993.29
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Advantage |
$621.06
|
| Rate for Payer: Cofinity Commercial |
$763.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$993.29
|
| Rate for Payer: Healthscope Commercial |
$798.51
|
| Rate for Payer: Mclaren Medicaid |
$519.49
|
| Rate for Payer: Mclaren Medicare |
$993.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.95
|
| Rate for Payer: Meridian Medicaid |
$1,042.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,142.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,092.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Nomi Health Commercial |
$2,979.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PACE Medicare |
$943.63
|
| Rate for Payer: PACE SWMI |
$993.29
|
| Rate for Payer: PHP Commercial |
$754.15
|
| Rate for Payer: PHP Medicare Advantage |
$993.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,212.23
|
| Rate for Payer: Priority Health Medicare |
$993.29
|
| Rate for Payer: Priority Health SBD |
$558.95
|
| Rate for Payer: Priority Health Tiered Network |
$2,569.78
|
| Rate for Payer: Railroad Medicare Medicare |
$993.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.70
|
| Rate for Payer: UHC Core |
$462.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$993.29
|
| Rate for Payer: UHC Exchange |
$348.68
|
| Rate for Payer: UHC Medicaid |
$519.49
|
| Rate for Payer: UHCCP Medicaid |
$519.49
|
| Rate for Payer: VA VA |
$993.29
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,076.72 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| 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 |
$1,076.72
|
| Rate for Payer: BCN Commercial |
$1,076.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| 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: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| 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 SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,178.07 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,178.07 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.59 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| 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 |
$153.59
|
| Rate for Payer: BCN Commercial |
$153.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| 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: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| 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 SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: VA VA |
$3,303.54
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$4,043.82
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,999.64 |
| Rate for Payer: Aetna Commercial |
$3,437.25
|
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,628.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.77
|
| Rate for Payer: BCN Commercial |
$1,008.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cofinity Advantage |
$2,830.67
|
| Rate for Payer: Cofinity Commercial |
$3,477.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,235.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,639.44
|
| Rate for Payer: Mclaren Medicaid |
$808.56
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$1,623.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,437.25
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,032.86
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$3,437.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,999.64
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health SBD |
$2,547.61
|
| Rate for Payer: Priority Health Tiered Network |
$3,999.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,628.48
|
| Rate for Payer: UHC Core |
$2,106.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$1,589.22
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
IP
|
$4,043.82
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,547.61 |
| Max. Negotiated Rate |
$3,639.44 |
| Rate for Payer: Aetna Commercial |
$3,437.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,628.48
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cofinity Advantage |
$2,830.67
|
| Rate for Payer: Cofinity Commercial |
$3,477.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,235.06
|
| Rate for Payer: Healthscope Commercial |
$3,639.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,437.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,032.86
|
| Rate for Payer: PHP Commercial |
$3,437.25
|
| Rate for Payer: Priority Health SBD |
$2,547.61
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.61 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| 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 |
$131.61
|
| Rate for Payer: BCN Commercial |
$131.61
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| 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 SBD |
$755.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.72
|
| Rate for Payer: UHC Core |
$624.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$471.43
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$755.73 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health SBD |
$755.73
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.61 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health SBD |
$385.61
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$148.71 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| 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 |
$148.71
|
| Rate for Payer: BCN Commercial |
$148.71
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$520.27
|
| 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 SBD |
$385.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.85
|
| Rate for Payer: UHC Core |
$318.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$240.55
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.55 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| 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: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| 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: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$520.27
|
| 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 SBD |
$385.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.85
|
| Rate for Payer: UHC Core |
$318.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$240.55
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.61 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health SBD |
$385.61
|
|
