|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
IP
|
$193.14
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$173.83 |
| Rate for Payer: Aetna Commercial |
$164.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.54
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cofinity Advantage |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$166.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.51
|
| Rate for Payer: Healthscope Commercial |
$173.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.85
|
| Rate for Payer: PHP Commercial |
$164.17
|
| Rate for Payer: Priority Health SBD |
$121.68
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
OP
|
$193.14
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$75.90 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$164.17
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.54
|
| 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 |
$125.67
|
| Rate for Payer: BCN Commercial |
$125.67
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cash Price |
$154.51
|
| Rate for Payer: Cofinity Advantage |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$166.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$173.83
|
| 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 |
$164.17
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.85
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$164.17
|
| 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 |
$121.68
|
| 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) |
$125.54
|
| Rate for Payer: UHC Core |
$100.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$75.90
|
| 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 TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.83 |
| 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 |
$143.83
|
| Rate for Payer: BCN Commercial |
$143.83
|
| 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 TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
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 TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$416.69
|
| Rate for Payer: BCN Commercial |
$416.69
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| 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 |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$385.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| 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 |
$405.05
|
| Rate for Payer: UHC Exchange |
$240.55
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
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 TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
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 TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$318.69
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$200.77 |
| Max. Negotiated Rate |
$286.82 |
| Rate for Payer: Aetna Commercial |
$270.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.15
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cofinity Advantage |
$223.08
|
| Rate for Payer: Cofinity Commercial |
$274.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.95
|
| Rate for Payer: Healthscope Commercial |
$286.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.02
|
| Rate for Payer: PHP Commercial |
$270.89
|
| Rate for Payer: Priority Health SBD |
$200.77
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$318.69
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.25 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$270.89
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.15
|
| 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 |
$847.31
|
| Rate for Payer: BCN Commercial |
$847.31
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cash Price |
$254.95
|
| Rate for Payer: Cofinity Advantage |
$223.08
|
| Rate for Payer: Cofinity Commercial |
$274.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$286.82
|
| 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 |
$270.89
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.02
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$270.89
|
| 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 |
$200.77
|
| 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) |
$207.15
|
| Rate for Payer: UHC Core |
$166.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$125.25
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$8,284.71
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,256.18 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna Commercial |
$7,042.00
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,385.06
|
| 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 |
$1,256.18
|
| Rate for Payer: BCN Commercial |
$1,256.18
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Advantage |
$5,799.30
|
| Rate for Payer: Cofinity Commercial |
$7,124.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,456.24
|
| 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 |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$7,042.00
|
| 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 |
$5,219.37
|
| 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) |
$5,385.06
|
| Rate for Payer: UHC Core |
$4,316.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,255.89
|
| 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 EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$8,284.71
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,219.37 |
| Max. Negotiated Rate |
$7,456.24 |
| Rate for Payer: Aetna Commercial |
$7,042.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,385.06
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Advantage |
$5,799.30
|
| Rate for Payer: Cofinity Commercial |
$7,124.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Healthscope Commercial |
$7,456.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PHP Commercial |
$7,042.00
|
| Rate for Payer: Priority Health SBD |
$5,219.37
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,323.40
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,613.74 |
| Max. Negotiated Rate |
$6,591.06 |
| Rate for Payer: Aetna Commercial |
$6,224.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,760.21
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cofinity Advantage |
$5,126.38
|
| Rate for Payer: Cofinity Commercial |
$6,298.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,858.72
|
| Rate for Payer: Healthscope Commercial |
$6,591.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,224.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,492.55
|
| Rate for Payer: PHP Commercial |
$6,224.89
|
| Rate for Payer: Priority Health SBD |
$4,613.74
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,323.40
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$6,224.89
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,760.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cash Price |
$5,858.72
|
| Rate for Payer: Cofinity Advantage |
$5,126.38
|
| Rate for Payer: Cofinity Commercial |
$6,298.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,858.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$6,591.06
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,224.89
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,492.55
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$6,224.89
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$4,613.74
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,760.21
|
| Rate for Payer: UHC Core |
$3,815.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$2,878.10
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$11,236.32
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$10,112.69 |
| Rate for Payer: Aetna Commercial |
$9,550.87
|
| Rate for Payer: Aetna Commercial |
$6,367.25
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,869.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,303.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Commercial |
$1,180.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cofinity Advantage |
$5,243.62
|
| Rate for Payer: Cofinity Advantage |
$7,865.42
|
| Rate for Payer: Cofinity Commercial |
$9,663.24
|
| Rate for Payer: Cofinity Commercial |
$6,442.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,992.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,989.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$10,112.69
|
| Rate for Payer: Healthscope Commercial |
$6,741.79
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,367.25
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,618.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,427.24
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$9,550.87
|
| Rate for Payer: PHP Commercial |
$6,367.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$4,719.25
|
| Rate for Payer: Priority Health SBD |
$7,078.88
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,303.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,869.07
|
| Rate for Payer: UHC Core |
$3,902.75
|
| Rate for Payer: UHC Core |
$5,854.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$2,943.92
|
| Rate for Payer: UHC Exchange |
$4,415.87
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: VA VA |
$2,894.27
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$11,236.32
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,078.88 |
| Max. Negotiated Rate |
$10,112.69 |
| Rate for Payer: Aetna Commercial |
$9,550.87
|
| Rate for Payer: Aetna Commercial |
$6,367.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,303.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,869.07
|
| Rate for Payer: Cash Price |
$8,989.06
|
| Rate for Payer: Cash Price |
$5,992.70
|
| Rate for Payer: Cofinity Advantage |
$7,865.42
|
| Rate for Payer: Cofinity Advantage |
$5,243.62
|
| Rate for Payer: Cofinity Commercial |
$9,663.24
|
| Rate for Payer: Cofinity Commercial |
$6,442.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,992.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,989.06
|
| Rate for Payer: Healthscope Commercial |
$6,741.79
|
| Rate for Payer: Healthscope Commercial |
$10,112.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,550.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,367.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,427.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,618.16
|
| Rate for Payer: PHP Commercial |
$9,550.87
|
| Rate for Payer: PHP Commercial |
$6,367.25
|
| Rate for Payer: Priority Health SBD |
$7,078.88
|
| Rate for Payer: Priority Health SBD |
$4,719.25
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.15 |
| 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 |
$151.15
|
| Rate for Payer: BCN Commercial |
$151.15
|
| 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 EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$4,057.56
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.56 |
| Max. Negotiated Rate |
$4,999.64 |
| Rate for Payer: Aetna Commercial |
$3,448.93
|
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.41
|
| 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 |
$1,144.52
|
| Rate for Payer: BCN Commercial |
$1,144.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cofinity Advantage |
$2,840.29
|
| Rate for Payer: Cofinity Commercial |
$3,489.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$3,651.80
|
| 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 |
$3,448.93
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,043.17
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$3,448.93
|
| 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 |
$2,556.26
|
| 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) |
$2,637.41
|
| Rate for Payer: UHC Core |
$2,113.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Exchange |
$1,594.62
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: VA VA |
$1,546.00
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$4,057.56
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,556.26 |
| Max. Negotiated Rate |
$3,651.80 |
| Rate for Payer: Aetna Commercial |
$3,448.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,637.41
|
| Rate for Payer: Cash Price |
$3,246.05
|
| Rate for Payer: Cofinity Advantage |
$2,840.29
|
| Rate for Payer: Cofinity Commercial |
$3,489.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.05
|
| Rate for Payer: Healthscope Commercial |
$3,651.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,448.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,043.17
|
| Rate for Payer: PHP Commercial |
$3,448.93
|
| Rate for Payer: Priority Health SBD |
$2,556.26
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$7,678.50
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Commercial |
$6,526.73
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,991.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,769.22
|
| Rate for Payer: BCN Commercial |
$1,769.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cofinity Advantage |
$5,374.95
|
| Rate for Payer: Cofinity Commercial |
$6,603.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,142.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$6,910.65
|
| Rate for Payer: Mclaren Medicaid |
$1,446.45
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,526.73
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,758.88
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$6,526.73
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$4,837.45
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,991.02
|
| Rate for Payer: UHC Core |
$4,000.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Exchange |
$3,017.65
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,678.50
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,837.45 |
| Max. Negotiated Rate |
$6,910.65 |
| Rate for Payer: Aetna Commercial |
$6,526.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,991.02
|
| Rate for Payer: Cash Price |
$6,142.80
|
| Rate for Payer: Cofinity Advantage |
$5,374.95
|
| Rate for Payer: Cofinity Commercial |
$6,603.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,142.80
|
| Rate for Payer: Healthscope Commercial |
$6,910.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,526.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,758.88
|
| Rate for Payer: PHP Commercial |
$6,526.73
|
| Rate for Payer: Priority Health SBD |
$4,837.45
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
IP
|
$403.71
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.34 |
| Max. Negotiated Rate |
$363.34 |
| Rate for Payer: Aetna Commercial |
$343.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.41
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cofinity Advantage |
$282.60
|
| Rate for Payer: Cofinity Commercial |
$347.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.97
|
| Rate for Payer: Healthscope Commercial |
$363.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.78
|
| Rate for Payer: PHP Commercial |
$343.15
|
| Rate for Payer: Priority Health SBD |
$254.34
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
OP
|
$403.71
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.66 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$343.15
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$307.60
|
| Rate for Payer: BCN Commercial |
$307.60
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cash Price |
$322.97
|
| Rate for Payer: Cofinity Advantage |
$282.60
|
| Rate for Payer: Cofinity Commercial |
$347.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$363.34
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.15
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$302.78
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$343.15
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$254.34
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.41
|
| Rate for Payer: UHC Core |
$210.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$158.66
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,383.36
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$3,391.52 |
| Max. Negotiated Rate |
$4,845.02 |
| Rate for Payer: Aetna Commercial |
$4,575.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,499.18
|
| Rate for Payer: Cash Price |
$4,306.69
|
| Rate for Payer: Cofinity Advantage |
$3,768.35
|
| Rate for Payer: Cofinity Commercial |
$4,629.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.69
|
| Rate for Payer: Healthscope Commercial |
$4,845.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,037.52
|
| Rate for Payer: PHP Commercial |
$4,575.86
|
| Rate for Payer: Priority Health SBD |
$3,391.52
|
|
