|
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 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 |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$119.29 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$160.95
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$170.41
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.95
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$160.95
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.08
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$119.29
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$170.41 |
| 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 |
$170.41
|
| 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 |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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 |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| 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 |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| 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 |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
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
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$312.44
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.84 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$265.57
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$249.95
|
| Rate for Payer: Cash Price |
$249.95
|
| Rate for Payer: Cofinity Commercial |
$268.70
|
| Rate for Payer: Cofinity Commercial |
$218.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$218.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$281.20
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.57
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$265.57
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.09
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$196.84
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$312.44
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.84 |
| Max. Negotiated Rate |
$281.20 |
| Rate for Payer: Aetna Commercial |
$265.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.09
|
| Rate for Payer: Cash Price |
$249.95
|
| Rate for Payer: Cofinity Commercial |
$218.71
|
| Rate for Payer: Cofinity Commercial |
$268.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$218.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.95
|
| Rate for Payer: Healthscope Commercial |
$281.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.57
|
| Rate for Payer: PHP Commercial |
$265.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.09
|
| Rate for Payer: Priority Health SBD |
$196.84
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Cofinity Commercial |
$5,685.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,685.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$5,117.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,780.71
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,117.02 |
| Max. Negotiated Rate |
$7,310.03 |
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$5,685.58
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,685.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health SBD |
$5,117.02
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,179.80
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$6,102.83
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,666.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$5,025.86
|
| Rate for Payer: Cofinity Commercial |
$6,174.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,025.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$6,461.82
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$6,102.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.87
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$4,523.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,179.80
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,523.27 |
| Max. Negotiated Rate |
$6,461.82 |
| Rate for Payer: Aetna Commercial |
$6,102.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,666.87
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$5,025.86
|
| Rate for Payer: Cofinity Commercial |
$6,174.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,025.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Healthscope Commercial |
$6,461.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: PHP Commercial |
$6,102.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.87
|
| Rate for Payer: Priority Health SBD |
$4,523.27
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$7,344.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$6,242.40
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,773.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$5,875.20
|
| Rate for Payer: Cash Price |
$5,875.20
|
| Rate for Payer: Cofinity Commercial |
$6,315.84
|
| Rate for Payer: Cofinity Commercial |
$5,140.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,875.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$6,609.60
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,242.40
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$6,242.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,773.60
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$4,626.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$7,344.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,626.72 |
| Max. Negotiated Rate |
$6,609.60 |
| Rate for Payer: Aetna Commercial |
$6,242.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,773.60
|
| Rate for Payer: Cash Price |
$5,875.20
|
| Rate for Payer: Cofinity Commercial |
$5,140.80
|
| Rate for Payer: Cofinity Commercial |
$6,315.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,875.20
|
| Rate for Payer: Healthscope Commercial |
$6,609.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,242.40
|
| Rate for Payer: PHP Commercial |
$6,242.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,773.60
|
| Rate for Payer: Priority Health SBD |
$4,626.72
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| 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 |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,780.71
|
| Rate for Payer: VA VA |
$3,162.90
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$774.34 |
| Max. Negotiated Rate |
$4,066.57 |
| Rate for Payer: Aetna Commercial |
$3,381.30
|
| Rate for Payer: Aetna Medicare |
$1,502.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,585.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cofinity Commercial |
$3,421.08
|
| Rate for Payer: Cofinity Commercial |
$2,784.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,784.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,182.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$3,580.20
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,381.30
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$3,381.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.70
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health SBD |
$2,506.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,066.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$813.34
|
| Rate for Payer: VA VA |
$1,444.66
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$3,978.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,506.14 |
| Max. Negotiated Rate |
$3,580.20 |
| Rate for Payer: Aetna Commercial |
$3,381.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,585.70
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cofinity Commercial |
$2,784.60
|
| Rate for Payer: Cofinity Commercial |
$3,421.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,784.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,182.40
|
| Rate for Payer: Healthscope Commercial |
$3,580.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,381.30
|
| Rate for Payer: PHP Commercial |
$3,381.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.70
|
| Rate for Payer: Priority Health SBD |
$2,506.14
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$7,527.94
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,433.59 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna Commercial |
$6,398.75
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,893.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$6,022.35
|
| Rate for Payer: Cash Price |
$6,022.35
|
| Rate for Payer: Cofinity Commercial |
$6,474.03
|
| Rate for Payer: Cofinity Commercial |
$5,269.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,269.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,022.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$6,775.15
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,398.75
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$6,398.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,893.16
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$4,742.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,505.80
|
| Rate for Payer: VA VA |
$2,674.60
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,527.94
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,742.60 |
| Max. Negotiated Rate |
$6,775.15 |
| Rate for Payer: Aetna Commercial |
$6,398.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,893.16
|
| Rate for Payer: Cash Price |
$6,022.35
|
| Rate for Payer: Cofinity Commercial |
$5,269.56
|
| Rate for Payer: Cofinity Commercial |
$6,474.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,269.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,022.35
|
| Rate for Payer: Healthscope Commercial |
$6,775.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,398.75
|
| Rate for Payer: PHP Commercial |
$6,398.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,893.16
|
| Rate for Payer: Priority Health SBD |
$4,742.60
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
OP
|
$395.79
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$336.42
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$316.63
|
| Rate for Payer: Cash Price |
$316.63
|
| Rate for Payer: Cofinity Commercial |
$340.38
|
| Rate for Payer: Cofinity Commercial |
$277.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$356.21
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.42
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$336.42
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.26
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$249.35
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
