|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
IP
|
$1,598.53
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,007.07 |
| Max. Negotiated Rate |
$1,438.68 |
| Rate for Payer: Aetna Commercial |
$1,358.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.04
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cofinity Advantage |
$1,118.97
|
| Rate for Payer: Cofinity Commercial |
$1,374.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,278.82
|
| Rate for Payer: Healthscope Commercial |
$1,438.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.90
|
| Rate for Payer: PHP Commercial |
$1,358.75
|
| Rate for Payer: Priority Health SBD |
$1,007.07
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
OP
|
$1,598.53
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Commercial |
$1,358.75
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,039.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$877.10
|
| Rate for Payer: BCN Commercial |
$877.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cofinity Advantage |
$1,118.97
|
| Rate for Payer: Cofinity Commercial |
$1,374.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,278.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,438.68
|
| Rate for Payer: Mclaren Medicaid |
$623.59
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.75
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.90
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,358.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$1,007.07
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.04
|
| Rate for Payer: UHC Core |
$832.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Exchange |
$628.22
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,379.41 |
| Max. Negotiated Rate |
$1,970.59 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| Rate for Payer: Priority Health SBD |
$1,379.41
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.49 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| 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 |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| 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 |
$1,379.41
|
| 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) |
$1,423.20
|
| Rate for Payer: UHC Core |
$1,140.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$860.49
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$172.79 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| 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 |
$172.79
|
| Rate for Payer: BCN Commercial |
$172.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| 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 |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| 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 |
$1,379.41
|
| 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) |
$1,423.20
|
| Rate for Payer: UHC Core |
$1,140.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$860.49
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,379.41 |
| Max. Negotiated Rate |
$1,970.59 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| Rate for Payer: Priority Health SBD |
$1,379.41
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,379.41 |
| Max. Negotiated Rate |
$1,970.59 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| Rate for Payer: Priority Health SBD |
$1,379.41
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$787.33 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| 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 |
$787.33
|
| Rate for Payer: BCN Commercial |
$787.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| 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 |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| 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 |
$1,379.41
|
| 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) |
$1,423.20
|
| Rate for Payer: UHC Core |
$1,140.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$860.49
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,379.41 |
| Max. Negotiated Rate |
$1,970.59 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| Rate for Payer: Priority Health SBD |
$1,379.41
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$814.47 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| 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 |
$814.47
|
| Rate for Payer: BCN Commercial |
$814.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| 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 |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| 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 |
$1,379.41
|
| 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) |
$1,423.20
|
| Rate for Payer: UHC Core |
$1,140.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$860.49
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
IP
|
$3,785.86
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,385.09 |
| Max. Negotiated Rate |
$3,407.27 |
| Rate for Payer: Aetna Commercial |
$3,217.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.81
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cofinity Advantage |
$2,650.10
|
| Rate for Payer: Cofinity Commercial |
$3,255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.69
|
| Rate for Payer: Healthscope Commercial |
$3,407.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.39
|
| Rate for Payer: PHP Commercial |
$3,217.98
|
| Rate for Payer: Priority Health SBD |
$2,385.09
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
OP
|
$3,785.86
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,377.78 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,217.98
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.81
|
| 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 |
$1,377.78
|
| Rate for Payer: BCN Commercial |
$1,377.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cofinity Advantage |
$2,650.10
|
| Rate for Payer: Cofinity Commercial |
$3,255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,407.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.98
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.39
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,217.98
|
| 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 |
$2,385.09
|
| 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) |
$2,460.81
|
| Rate for Payer: UHC Core |
$1,972.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,487.84
|
| 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 EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
IP
|
$2,189.54
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,379.41 |
| Max. Negotiated Rate |
$1,970.59 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,861.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| Rate for Payer: Priority Health SBD |
$1,379.41
|
|
|
HC EXC SKIN MALIG >4 CM TRUNK, ARM, LEG
|
Facility
|
OP
|
$2,189.54
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
76100211
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.49 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$1,861.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,423.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,734.87
|
| Rate for Payer: BCN Commercial |
$1,734.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cash Price |
$1,751.63
|
| Rate for Payer: Cofinity Advantage |
$1,532.68
|
| Rate for Payer: Cofinity Commercial |
$1,883.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,751.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,970.59
|
| 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 |
$1,861.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,642.15
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,861.11
|
| 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 |
$1,379.41
|
| 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) |
$1,423.20
|
| Rate for Payer: UHC Core |
$1,140.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$860.49
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
OP
|
$3,785.86
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$3,217.98
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.81
|
| 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 |
$3,028.69
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cofinity Advantage |
$2,650.10
|
| Rate for Payer: Cofinity Commercial |
$3,255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,407.27
|
| Rate for Payer: Mclaren Medicaid |
$1,513.70
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.98
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.39
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,217.98
|
| 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 |
$2,385.09
|
| 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) |
$2,460.81
|
| Rate for Payer: UHC Core |
$1,972.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,487.84
|
| 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 EXC SKIN MALIG >4 REMAINDER BODY
|
Facility
|
IP
|
$3,785.86
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
76100214
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,385.09 |
| Max. Negotiated Rate |
$3,407.27 |
| Rate for Payer: Aetna Commercial |
$3,217.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,460.81
|
| Rate for Payer: Cash Price |
$3,028.69
|
| Rate for Payer: Cofinity Advantage |
$2,650.10
|
| Rate for Payer: Cofinity Commercial |
$3,255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,028.69
|
| Rate for Payer: Healthscope Commercial |
$3,407.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,217.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,839.39
|
| Rate for Payer: PHP Commercial |
$3,217.98
|
| Rate for Payer: Priority Health SBD |
$2,385.09
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
OP
|
$3,301.29
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$115.54 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Commercial |
$2,806.10
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,145.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$115.54
|
| Rate for Payer: BCN Commercial |
$115.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$2,641.03
|
| Rate for Payer: Cash Price |
$2,641.03
|
| Rate for Payer: Cash Price |
$2,641.03
|
| Rate for Payer: Cofinity Advantage |
$2,310.90
|
| Rate for Payer: Cofinity Commercial |
$2,839.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$2,971.16
|
| Rate for Payer: Mclaren Medicaid |
$623.59
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,806.10
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,475.97
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$2,806.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$2,079.81
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
HC EXC THROMBOSED HEMORRHOID EXTERN
|
Facility
|
IP
|
$3,301.29
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
36000106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,079.81 |
| Max. Negotiated Rate |
$2,971.16 |
| Rate for Payer: Aetna Commercial |
$2,806.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,145.84
|
| Rate for Payer: Cash Price |
$2,641.03
|
| Rate for Payer: Cofinity Advantage |
$2,310.90
|
| Rate for Payer: Cofinity Commercial |
$2,839.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.03
|
| Rate for Payer: Healthscope Commercial |
$2,971.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,806.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,475.97
|
| Rate for Payer: PHP Commercial |
$2,806.10
|
| Rate for Payer: Priority Health SBD |
$2,079.81
|
|
|
HC EXC TUMOR SOFT TISS FACE AND SCALP SUBFASCIAL <2CM
|
Facility
|
IP
|
$4,630.80
|
|
|
Service Code
|
CPT 21013
|
| Hospital Charge Code |
76100526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,917.40 |
| Max. Negotiated Rate |
$4,167.72 |
| Rate for Payer: Aetna Commercial |
$3,936.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,010.02
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cofinity Advantage |
$3,241.56
|
| Rate for Payer: Cofinity Commercial |
$3,982.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,704.64
|
| Rate for Payer: Healthscope Commercial |
$4,167.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,936.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,473.10
|
| Rate for Payer: PHP Commercial |
$3,936.18
|
| Rate for Payer: Priority Health SBD |
$2,917.40
|
|
|
HC EXC TUMOR SOFT TISS FACE AND SCALP SUBFASCIAL <2CM
|
Facility
|
OP
|
$4,630.80
|
|
|
Service Code
|
CPT 21013
|
| Hospital Charge Code |
76100526
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,936.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,010.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.38
|
| Rate for Payer: BCN Commercial |
$1,236.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cofinity Advantage |
$3,241.56
|
| Rate for Payer: Cofinity Commercial |
$3,982.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,704.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,167.72
|
| 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 |
$3,936.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,473.10
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,936.18
|
| 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 |
$2,917.40
|
| 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) |
$3,010.02
|
| Rate for Payer: UHC Core |
$2,412.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,819.90
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Facility
|
OP
|
$4,630.80
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
76100431
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$3,936.18
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,010.02
|
| 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 |
$1,085.97
|
| Rate for Payer: BCN Commercial |
$1,085.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cofinity Advantage |
$3,241.56
|
| Rate for Payer: Cofinity Commercial |
$3,982.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,704.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$4,167.72
|
| 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 |
$3,936.18
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,473.10
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,936.18
|
| 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 |
$2,917.40
|
| 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) |
$3,010.02
|
| Rate for Payer: UHC Core |
$2,412.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,819.90
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
HC EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>
|
Facility
|
IP
|
$4,630.80
|
|
|
Service Code
|
CPT 25071
|
| Hospital Charge Code |
76100431
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,917.40 |
| Max. Negotiated Rate |
$4,167.72 |
| Rate for Payer: Aetna Commercial |
$3,936.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,010.02
|
| Rate for Payer: Cash Price |
$3,704.64
|
| Rate for Payer: Cofinity Advantage |
$3,241.56
|
| Rate for Payer: Cofinity Commercial |
$3,982.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,704.64
|
| Rate for Payer: Healthscope Commercial |
$4,167.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,936.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,473.10
|
| Rate for Payer: PHP Commercial |
$3,936.18
|
| Rate for Payer: Priority Health SBD |
$2,917.40
|
|
|
HC EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
OP
|
$8,273.26
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
76100413
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.96 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna Commercial |
$7,032.27
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,377.62
|
| 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 |
$6,618.61
|
| Rate for Payer: Cash Price |
$6,618.61
|
| Rate for Payer: Cash Price |
$6,618.61
|
| Rate for Payer: Cofinity Advantage |
$5,791.28
|
| Rate for Payer: Cofinity Commercial |
$7,115.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,618.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,445.93
|
| 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 |
$7,032.27
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,204.94
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$7,032.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$5,212.15
|
| 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) |
$5,377.62
|
| Rate for Payer: UHC Core |
$4,310.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$3,251.39
|
| 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 EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Facility
|
IP
|
$8,273.26
|
|
|
Service Code
|
CPT 23076
|
| Hospital Charge Code |
76100413
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,212.15 |
| Max. Negotiated Rate |
$7,445.93 |
| Rate for Payer: Aetna Commercial |
$7,032.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,377.62
|
| Rate for Payer: Cash Price |
$6,618.61
|
| Rate for Payer: Cofinity Advantage |
$5,791.28
|
| Rate for Payer: Cofinity Commercial |
$7,115.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,618.61
|
| Rate for Payer: Healthscope Commercial |
$7,445.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,032.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,204.94
|
| Rate for Payer: PHP Commercial |
$7,032.27
|
| Rate for Payer: Priority Health SBD |
$5,212.15
|
|
|
HC EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ >3CM
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 22903
|
| Hospital Charge Code |
76100245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,325.49 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,399.31
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Advantage |
$2,583.88
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health SBD |
$2,325.49
|
|
