|
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
|
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 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 |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$265.57
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.09
|
| 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 |
$661.50
|
| Rate for Payer: BCN Commercial |
$661.50
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$249.95
|
| 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 |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$281.20
|
| 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 |
$265.57
|
| 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 |
$265.57
|
| 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 |
$203.09
|
| 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 |
$196.84
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.49
|
| 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 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/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 |
$175.79 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| 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 |
$980.72
|
| Rate for Payer: BCN Commercial |
$980.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,497.81
|
| 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 |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| 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 |
$6,903.92
|
| 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 |
$6,903.92
|
| 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 |
$5,279.47
|
| 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 |
$5,117.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.79
|
| 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 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 |
$782.29 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$6,102.83
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,666.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$6,174.63
|
| Rate for Payer: Cofinity Commercial |
$5,025.86
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$6,461.82
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$6,102.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$4,523.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$782.29
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
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 |
$341.40 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$6,242.40
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,773.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$5,875.20
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$6,609.60
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,242.40
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$6,242.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,773.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$4,626.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.40
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
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 |
$118.00 |
| 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 |
$118.00
|
| Rate for Payer: BCN Commercial |
$118.00
|
| 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) |
$136.04
|
| 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 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
|
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 LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.13 |
| Max. Negotiated Rate |
$4,561.52 |
| Rate for Payer: Aetna Commercial |
$3,381.30
|
| Rate for Payer: Aetna Medicare |
$1,509.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,585.70
|
| 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 |
$893.55
|
| Rate for Payer: BCN Commercial |
$893.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.33
|
| Rate for Payer: Cash Price |
$3,182.40
|
| 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 |
$1,451.33
|
| Rate for Payer: Healthscope Commercial |
$3,580.20
|
| 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 |
$3,381.30
|
| 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 |
$3,381.30
|
| 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 |
$2,585.70
|
| 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 |
$2,506.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.13
|
| 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 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 |
$146.36 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Commercial |
$6,398.75
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,893.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,381.26
|
| Rate for Payer: BCN Commercial |
$1,381.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$6,022.35
|
| 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 |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$6,775.15
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,398.75
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$6,398.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,893.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$4,742.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.36
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,512.75
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
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
|
IP
|
$395.79
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$249.35 |
| Max. Negotiated Rate |
$356.21 |
| Rate for Payer: Aetna Commercial |
$336.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.26
|
| Rate for Payer: Cash Price |
$316.63
|
| Rate for Payer: Cofinity Commercial |
$277.05
|
| Rate for Payer: Cofinity Commercial |
$340.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$277.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.63
|
| Rate for Payer: Healthscope Commercial |
$356.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.42
|
| Rate for Payer: PHP Commercial |
$336.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.26
|
| Rate for Payer: Priority Health SBD |
$249.35
|
|
|
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 |
$106.70 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$336.42
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.26
|
| 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 |
$240.15
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$316.63
|
| 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 |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$356.21
|
| 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 |
$336.42
|
| 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 |
$336.42
|
| 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 |
$257.26
|
| 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 |
$249.35
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.70
|
| 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 EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,277.80
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$3,325.01 |
| Max. Negotiated Rate |
$4,750.02 |
| Rate for Payer: Aetna Commercial |
$4,486.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,430.57
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cofinity Commercial |
$3,694.46
|
| Rate for Payer: Cofinity Commercial |
$4,538.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,694.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,222.24
|
| Rate for Payer: Healthscope Commercial |
$4,750.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,486.13
|
| Rate for Payer: PHP Commercial |
$4,486.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,430.57
|
| Rate for Payer: Priority Health SBD |
$3,325.01
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$5,277.80
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$138.88 |
| Max. Negotiated Rate |
$5,632.99 |
| Rate for Payer: Aetna Commercial |
$4,486.13
|
| Rate for Payer: Aetna Medicare |
$1,863.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,430.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.89
|
| Rate for Payer: BCN Commercial |
$1,075.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cash Price |
$4,222.24
|
| Rate for Payer: Cofinity Commercial |
$4,538.91
|
| Rate for Payer: Cofinity Commercial |
$3,694.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,694.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,222.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$4,750.02
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,486.13
|
| Rate for Payer: Nomi Health Commercial |
$3,763.70
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$4,486.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,430.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,632.99
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,506.39
|
| Rate for Payer: Priority Health SBD |
$3,325.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.88
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$1,009.03
|
| Rate for Payer: VA VA |
$1,792.24
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$3,945.22
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$2,485.49 |
| Max. Negotiated Rate |
$3,550.70 |
| Rate for Payer: Aetna Commercial |
$3,353.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,564.39
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cofinity Commercial |
$2,761.65
|
| Rate for Payer: Cofinity Commercial |
$3,392.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,761.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.18
|
| Rate for Payer: Healthscope Commercial |
$3,550.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,353.44
|
| Rate for Payer: PHP Commercial |
$3,353.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.39
|
| Rate for Payer: Priority Health SBD |
$2,485.49
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$3,945.22
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$197.94 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$3,353.44
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,564.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,680.56
|
| Rate for Payer: BCN Commercial |
$1,680.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cash Price |
$3,156.18
|
| Rate for Payer: Cofinity Commercial |
$3,392.89
|
| Rate for Payer: Cofinity Commercial |
$2,761.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,761.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$3,550.70
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,353.44
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$3,353.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,564.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$2,485.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.94
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
IP
|
$7,162.94
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,512.65 |
| Max. Negotiated Rate |
$6,446.65 |
| Rate for Payer: Aetna Commercial |
$6,088.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,655.91
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cofinity Commercial |
$5,014.06
|
| Rate for Payer: Cofinity Commercial |
$6,160.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,014.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,730.35
|
| Rate for Payer: Healthscope Commercial |
$6,446.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,088.50
|
| Rate for Payer: PHP Commercial |
$6,088.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,655.91
|
| Rate for Payer: Priority Health SBD |
$4,512.65
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
OP
|
$7,162.94
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.67 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$6,088.50
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,655.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cash Price |
$5,730.35
|
| Rate for Payer: Cofinity Commercial |
$6,160.13
|
| Rate for Payer: Cofinity Commercial |
$5,014.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,014.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,730.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$6,446.65
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,088.50
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$6,088.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,655.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$4,512.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.67
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
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 TONSIL TAGS
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$205.16 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| 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 |
$1,737.04
|
| Rate for Payer: BCN Commercial |
$1,737.04
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,497.81
|
| 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 |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| 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 |
$6,903.92
|
| 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 |
$6,903.92
|
| 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 |
$5,279.47
|
| 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 |
$5,117.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.16
|
| 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
|
|
