|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,118.85
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,334.88 |
| Max. Negotiated Rate |
$1,906.96 |
| Rate for Payer: Aetna Commercial |
$1,801.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.25
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cofinity Commercial |
$1,483.20
|
| Rate for Payer: Cofinity Commercial |
$1,822.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,483.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,695.08
|
| Rate for Payer: Healthscope Commercial |
$1,906.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,801.02
|
| Rate for Payer: PHP Commercial |
$1,801.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.25
|
| Rate for Payer: Priority Health SBD |
$1,334.88
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,118.85
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$263.28 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$1,801.02
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,377.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.45
|
| Rate for Payer: BCN Commercial |
$1,436.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cash Price |
$1,695.08
|
| Rate for Payer: Cofinity Commercial |
$1,822.21
|
| Rate for Payer: Cofinity Commercial |
$1,483.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,483.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,695.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,906.96
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,801.02
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,801.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,377.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,334.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.28
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,727.92
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,978.59 |
| Max. Negotiated Rate |
$4,255.13 |
| Rate for Payer: Aetna Commercial |
$4,018.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,073.15
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cofinity Commercial |
$3,309.54
|
| Rate for Payer: Cofinity Commercial |
$4,066.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,309.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,782.34
|
| Rate for Payer: Healthscope Commercial |
$4,255.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,018.73
|
| Rate for Payer: PHP Commercial |
$4,018.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,073.15
|
| Rate for Payer: Priority Health SBD |
$2,978.59
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,727.92
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$448.26 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna Commercial |
$4,018.73
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,073.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,689.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,689.81
|
| Rate for Payer: BCBS Complete |
$2,111.54
|
| Rate for Payer: BCBS MAPPO |
$3,751.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.88
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$1,599.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cash Price |
$3,782.34
|
| Rate for Payer: Cofinity Commercial |
$4,066.01
|
| Rate for Payer: Cofinity Commercial |
$3,309.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,309.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,782.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$4,255.13
|
| Rate for Payer: Mclaren Medicaid |
$2,010.99
|
| Rate for Payer: Mclaren Medicare |
$3,751.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,939.44
|
| Rate for Payer: Meridian Medicaid |
$2,111.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,314.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,018.73
|
| Rate for Payer: Nomi Health Commercial |
$7,878.88
|
| Rate for Payer: PACE Medicare |
$3,564.26
|
| Rate for Payer: PACE SWMI |
$3,751.85
|
| Rate for Payer: PHP Commercial |
$4,018.73
|
| Rate for Payer: PHP Medicare Advantage |
$3,751.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,010.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,073.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.02
|
| Rate for Payer: Priority Health Medicare |
$3,751.85
|
| Rate for Payer: Priority Health Narrow Network |
$9,433.62
|
| Rate for Payer: Priority Health SBD |
$2,978.59
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.26
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,112.29
|
| Rate for Payer: VA VA |
$3,751.85
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$869.83
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$547.99 |
| Max. Negotiated Rate |
$782.85 |
| Rate for Payer: Aetna Commercial |
$739.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.39
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cofinity Commercial |
$608.88
|
| Rate for Payer: Cofinity Commercial |
$748.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$608.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.86
|
| Rate for Payer: Healthscope Commercial |
$782.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.36
|
| Rate for Payer: PHP Commercial |
$739.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$565.39
|
| Rate for Payer: Priority Health SBD |
$547.99
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$869.83
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.18 |
| Max. Negotiated Rate |
$3,138.00 |
| Rate for Payer: Aetna Commercial |
$739.36
|
| Rate for Payer: Aetna Medicare |
$986.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$565.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,186.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,186.20
|
| Rate for Payer: BCBS Complete |
$534.07
|
| Rate for Payer: BCBS MAPPO |
$948.96
|
| Rate for Payer: BCBS Trust/PPO |
$150.18
|
| Rate for Payer: BCN Commercial |
$150.18
|
| Rate for Payer: BCN Medicare Advantage |
$948.96
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cash Price |
$695.86
|
| Rate for Payer: Cofinity Commercial |
$748.05
|
| Rate for Payer: Cofinity Commercial |
$608.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$608.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$948.96
|
| Rate for Payer: Healthscope Commercial |
$782.85
|
| Rate for Payer: Mclaren Medicaid |
$508.64
|
| Rate for Payer: Mclaren Medicare |
$948.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$996.41
|
| Rate for Payer: Meridian Medicaid |
$534.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,091.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$739.36
|
| Rate for Payer: Nomi Health Commercial |
$1,992.82
|
| Rate for Payer: PACE Medicare |
$901.51
|
| Rate for Payer: PACE SWMI |
$948.96
|
| Rate for Payer: PHP Commercial |
$739.36
|
| Rate for Payer: PHP Medicare Advantage |
$948.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$565.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,982.54
|
| Rate for Payer: Priority Health Medicare |
$948.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,386.03
|
| Rate for Payer: Priority Health SBD |
$547.99
|
| Rate for Payer: Railroad Medicare Medicare |
$948.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.55
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$948.96
|
| Rate for Payer: UHC Medicare Advantage |
$948.96
|
| Rate for Payer: UHCCP Medicaid |
$534.26
|
| Rate for Payer: VA VA |
$948.96
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$294.62 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$840.61
|
| Rate for Payer: BCN Commercial |
$840.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.62
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,788.93
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,076.54 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.91 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$119.91
|
| Rate for Payer: BCN Commercial |
$119.91
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.37
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,788.93
|
| Rate for Payer: VA VA |
$3,177.50
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,076.54 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
IP
|
$3,964.53
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,497.65 |
| Max. Negotiated Rate |
$3,568.08 |
| Rate for Payer: Aetna Commercial |
$3,369.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,576.94
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cofinity Commercial |
$2,775.17
|
| Rate for Payer: Cofinity Commercial |
$3,409.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,775.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,171.62
|
| Rate for Payer: Healthscope Commercial |
$3,568.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,369.85
|
| Rate for Payer: PHP Commercial |
$3,369.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,576.94
|
| Rate for Payer: Priority Health SBD |
$2,497.65
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$3,964.53
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.52 |
| Max. Negotiated Rate |
$4,561.52 |
| Rate for Payer: Aetna Commercial |
$3,369.85
|
| Rate for Payer: Aetna Medicare |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,576.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,814.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,814.16
|
| Rate for Payer: BCBS Complete |
$816.81
|
| Rate for Payer: BCBS MAPPO |
$1,451.33
|
| Rate for Payer: BCBS Trust/PPO |
$787.56
|
| Rate for Payer: BCN Commercial |
$787.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cash Price |
$3,171.62
|
| Rate for Payer: Cofinity Commercial |
$3,409.50
|
| Rate for Payer: Cofinity Commercial |
$2,775.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,775.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,171.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$3,568.08
|
| Rate for Payer: Mclaren Medicaid |
$777.91
|
| Rate for Payer: Mclaren Medicare |
$1,451.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,523.90
|
| Rate for Payer: Meridian Medicaid |
$816.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,669.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,369.85
|
| Rate for Payer: Nomi Health Commercial |
$3,047.79
|
| Rate for Payer: PACE Medicare |
$1,378.76
|
| Rate for Payer: PACE SWMI |
$1,451.33
|
| Rate for Payer: PHP Commercial |
$3,369.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$777.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,576.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,561.52
|
| Rate for Payer: Priority Health Medicare |
$1,451.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,649.22
|
| Rate for Payer: Priority Health SBD |
$2,497.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.52
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,451.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,451.33
|
| Rate for Payer: UHCCP Medicaid |
$817.10
|
| Rate for Payer: VA VA |
$1,451.33
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$740.91 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health SBD |
$740.91
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$102.75
|
| Rate for Payer: BCN Commercial |
$102.75
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.35
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$116.10
|
| Rate for Payer: BCN Commercial |
$116.10
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.42
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health SBD |
$378.05
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$190.44 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$417.74
|
| Rate for Payer: BCN Commercial |
$417.74
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health SBD |
$378.05
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
OP
|
$189.35
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.11 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$98.11
|
| Rate for Payer: BCN Commercial |
$98.11
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$162.84
|
| Rate for Payer: Cofinity Commercial |
$132.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$170.42
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$119.29
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.05
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
IP
|
$189.35
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.29 |
| Max. Negotiated Rate |
$170.42 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.08
|
| Rate for Payer: Cash Price |
$151.48
|
| Rate for Payer: Cofinity Commercial |
$132.54
|
| Rate for Payer: Cofinity Commercial |
$162.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.48
|
| Rate for Payer: Healthscope Commercial |
$170.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.08
|
| Rate for Payer: Priority Health SBD |
$119.29
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.29 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$112.29
|
| Rate for Payer: BCN Commercial |
$112.29
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.01
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health SBD |
$378.05
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health SBD |
$378.05
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.12 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$325.31
|
| Rate for Payer: BCN Commercial |
$325.31
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.12
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$740.91 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health SBD |
$740.91
|
|
