|
PR EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI
|
Professional
|
Both
|
$809.00
|
|
|
Service Code
|
HCPCS 34717
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$78,572.00 |
| Rate for Payer: Aetna Commercial |
$568.63
|
| Rate for Payer: Aetna Medicare |
$441.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$611.06
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$424.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,145.35
|
| Rate for Payer: BCN Commercial |
$629.42
|
| Rate for Payer: BCN Medicare Advantage |
$424.35
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cash Price |
$647.20
|
| Rate for Payer: Cofinity Commercial |
$611.06
|
| Rate for Payer: Cofinity Commercial |
$568.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$424.35
|
| Rate for Payer: Healthscope Commercial |
$678.96
|
| Rate for Payer: Healthscope Commercial |
$785.05
|
| Rate for Payer: Mclaren Medicaid |
$274.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$445.57
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,572.00
|
| Rate for Payer: Nomi Health Commercial |
$509.22
|
| Rate for Payer: PACE SWMI |
$424.35
|
| Rate for Payer: PHP Medicare Advantage |
$424.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$686.58
|
| Rate for Payer: Priority Health Medicare |
$424.35
|
| Rate for Payer: Priority Health Narrow Network |
$686.58
|
| Rate for Payer: Priority Health SBD |
$686.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$424.35
|
| Rate for Payer: UHC Medicare Advantage |
$424.35
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK
|
Professional
|
Both
|
$3,336.00
|
|
|
Service Code
|
HCPCS 61623
|
| Min. Negotiated Rate |
$124.15 |
| Max. Negotiated Rate |
$103,705.00 |
| Rate for Payer: Aetna Commercial |
$756.03
|
| Rate for Payer: Aetna Medicare |
$586.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$756.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.45
|
| Rate for Payer: BCBS Complete |
$386.91
|
| Rate for Payer: BCBS MAPPO |
$564.20
|
| Rate for Payer: BCBS Trust/PPO |
$124.15
|
| Rate for Payer: BCN Commercial |
$838.57
|
| Rate for Payer: BCN Medicare Advantage |
$564.20
|
| Rate for Payer: Cash Price |
$2,668.80
|
| Rate for Payer: Cash Price |
$2,668.80
|
| Rate for Payer: Cofinity Commercial |
$812.45
|
| Rate for Payer: Cofinity Commercial |
$756.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$564.20
|
| Rate for Payer: Healthscope Commercial |
$902.72
|
| Rate for Payer: Healthscope Commercial |
$1,043.77
|
| Rate for Payer: Mclaren Medicaid |
$368.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$592.41
|
| Rate for Payer: Meridian Medicaid |
$386.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103,705.00
|
| Rate for Payer: Nomi Health Commercial |
$677.04
|
| Rate for Payer: PACE SWMI |
$564.20
|
| Rate for Payer: PHP Medicare Advantage |
$564.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,168.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$980.47
|
| Rate for Payer: Priority Health Medicare |
$564.20
|
| Rate for Payer: Priority Health Narrow Network |
$980.47
|
| Rate for Payer: Priority Health SBD |
$980.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$564.20
|
| Rate for Payer: UHC Exchange |
$621.16
|
| Rate for Payer: UHC Medicare Advantage |
$564.20
|
| Rate for Payer: UHCCP Medicaid |
$368.49
|
|
|
PR EWHO RIGID W/O JNTS CF
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS L3763
|
| Min. Negotiated Rate |
$279.60 |
| Max. Negotiated Rate |
$78,104.00 |
| Rate for Payer: BCBS Complete |
$279.60
|
| Rate for Payer: BCN Commercial |
$646.68
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78,104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.35
|
|
|
PR EWHO W/JOINT(S) CF
|
Professional
|
Both
|
$731.00
|
|
|
Service Code
|
HCPCS L3764
|
| Min. Negotiated Rate |
$292.40 |
| Max. Negotiated Rate |
$81,738.00 |
| Rate for Payer: BCBS Complete |
$292.40
|
| Rate for Payer: BCN Commercial |
$676.76
|
| Rate for Payer: Cash Price |
$584.80
|
| Rate for Payer: Cash Price |
$584.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81,738.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.15
|
|
|
PR EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM
|
Professional
|
Both
|
$2,379.00
|
|
|
Service Code
|
HCPCS 44110
|
| Min. Negotiated Rate |
$545.71 |
| Max. Negotiated Rate |
$150,971.00 |
| Rate for Payer: Aetna Commercial |
$1,100.45
|
| Rate for Payer: Aetna Medicare |
$854.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,182.57
|
| Rate for Payer: BCBS Complete |
$573.00
|
| Rate for Payer: BCBS MAPPO |
$821.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.01
|
| Rate for Payer: BCN Commercial |
$1,234.88
|
| Rate for Payer: BCN Medicare Advantage |
$821.23
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cash Price |
$1,903.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.57
|
| Rate for Payer: Cofinity Commercial |
$1,100.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.23
|
| Rate for Payer: Healthscope Commercial |
$1,519.28
|
| Rate for Payer: Healthscope Commercial |
$1,313.97
|
| Rate for Payer: Mclaren Medicaid |
$545.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.29
|
| Rate for Payer: Meridian Medicaid |
$573.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150,971.00
|
| Rate for Payer: Nomi Health Commercial |
$985.48
|
| Rate for Payer: PACE SWMI |
$821.23
|
| Rate for Payer: PHP Medicare Advantage |
$821.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,546.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,523.10
|
| Rate for Payer: Priority Health Medicare |
$821.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,523.10
|
| Rate for Payer: Priority Health SBD |
$1,523.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$887.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.23
|
| Rate for Payer: UHC Exchange |
$887.89
|
| Rate for Payer: UHC Medicare Advantage |
$821.23
|
| Rate for Payer: UHCCP Medicaid |
$545.71
|
|
|
PR EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE
|
Professional
|
Both
|
$3,605.00
|
|
|
Service Code
|
HCPCS 44111
|
| Min. Negotiated Rate |
$266.79 |
| Max. Negotiated Rate |
$175,725.00 |
| Rate for Payer: Aetna Commercial |
$1,266.86
|
| Rate for Payer: Aetna Medicare |
$983.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,361.40
|
| Rate for Payer: BCBS Complete |
$659.32
|
| Rate for Payer: BCBS MAPPO |
$945.42
|
| Rate for Payer: BCBS Trust/PPO |
$266.79
|
| Rate for Payer: BCN Commercial |
$1,435.25
|
| Rate for Payer: BCN Medicare Advantage |
$945.42
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Cofinity Commercial |
$1,361.40
|
| Rate for Payer: Cofinity Commercial |
$1,266.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.42
|
| Rate for Payer: Healthscope Commercial |
$1,749.03
|
| Rate for Payer: Healthscope Commercial |
$1,512.67
|
| Rate for Payer: Mclaren Medicaid |
$627.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.69
|
| Rate for Payer: Meridian Medicaid |
$659.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175,725.00
|
| Rate for Payer: Nomi Health Commercial |
$1,134.50
|
| Rate for Payer: PACE SWMI |
$945.42
|
| Rate for Payer: PHP Medicare Advantage |
$945.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$627.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,343.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,748.62
|
| Rate for Payer: Priority Health Medicare |
$945.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,748.62
|
| Rate for Payer: Priority Health SBD |
$1,748.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,080.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$945.42
|
| Rate for Payer: UHC Exchange |
$1,080.83
|
| Rate for Payer: UHC Medicare Advantage |
$945.42
|
| Rate for Payer: UHCCP Medicaid |
$627.92
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
11440
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$110.72 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.60
|
| 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 |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Cofinity Commercial |
$156.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$201.60
|
| 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 |
$190.40
|
| 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 |
$190.40
|
| 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 |
$145.60
|
| 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 |
$141.12
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.72
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 11440
|
| Hospital Charge Code |
11440
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$18,295.00 |
| Rate for Payer: Aetna Commercial |
$134.13
|
| Rate for Payer: Aetna Medicare |
$104.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.14
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS MAPPO |
$100.10
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$100.10
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$144.14
|
| Rate for Payer: Cofinity Commercial |
$134.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.10
|
| Rate for Payer: Healthscope Commercial |
$185.18
|
| Rate for Payer: Healthscope Commercial |
$160.16
|
| Rate for Payer: Mclaren Medicaid |
$69.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.10
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,295.00
|
| Rate for Payer: Nomi Health Commercial |
$120.12
|
| Rate for Payer: PACE SWMI |
$100.10
|
| Rate for Payer: PHP Medicare Advantage |
$100.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.29
|
| Rate for Payer: Priority Health Medicare |
$100.10
|
| Rate for Payer: Priority Health Narrow Network |
$146.29
|
| Rate for Payer: Priority Health SBD |
$146.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.10
|
| Rate for Payer: UHC Exchange |
$136.15
|
| Rate for Payer: UHC Medicare Advantage |
$100.10
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
11440
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$141.12 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.60
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.20
|
| Rate for Payer: Healthscope Commercial |
$201.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.40
|
| Rate for Payer: PHP Commercial |
$190.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health SBD |
$141.12
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 11440
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$18,295.00 |
| Rate for Payer: Aetna Commercial |
$134.13
|
| Rate for Payer: Aetna Medicare |
$104.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.14
|
| Rate for Payer: BCBS Complete |
$72.91
|
| Rate for Payer: BCBS MAPPO |
$100.10
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$169.24
|
| Rate for Payer: BCN Medicare Advantage |
$100.10
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$144.14
|
| Rate for Payer: Cofinity Commercial |
$134.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.10
|
| Rate for Payer: Healthscope Commercial |
$185.18
|
| Rate for Payer: Healthscope Commercial |
$160.16
|
| Rate for Payer: Mclaren Medicaid |
$69.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.10
|
| Rate for Payer: Meridian Medicaid |
$72.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,295.00
|
| Rate for Payer: Nomi Health Commercial |
$120.12
|
| Rate for Payer: PACE SWMI |
$100.10
|
| Rate for Payer: PHP Medicare Advantage |
$100.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.29
|
| Rate for Payer: Priority Health Medicare |
$100.10
|
| Rate for Payer: Priority Health Narrow Network |
$146.29
|
| Rate for Payer: Priority Health SBD |
$146.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.10
|
| Rate for Payer: UHC Exchange |
$136.15
|
| Rate for Payer: UHC Medicare Advantage |
$100.10
|
| Rate for Payer: UHCCP Medicaid |
$69.44
|
|
|
PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 11446
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$55,550.00 |
| Rate for Payer: Aetna Commercial |
$407.40
|
| Rate for Payer: Aetna Medicare |
$316.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.80
|
| Rate for Payer: BCBS Complete |
$215.83
|
| Rate for Payer: BCBS MAPPO |
$304.03
|
| Rate for Payer: BCBS Trust/PPO |
$150.00
|
| Rate for Payer: BCN Commercial |
$449.99
|
| Rate for Payer: BCN Medicare Advantage |
$304.03
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Cofinity Commercial |
$407.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.03
|
| Rate for Payer: Healthscope Commercial |
$562.46
|
| Rate for Payer: Healthscope Commercial |
$486.45
|
| Rate for Payer: Mclaren Medicaid |
$205.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.23
|
| Rate for Payer: Meridian Medicaid |
$215.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,550.00
|
| Rate for Payer: Nomi Health Commercial |
$364.84
|
| Rate for Payer: PACE SWMI |
$304.03
|
| Rate for Payer: PHP Medicare Advantage |
$304.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$430.30
|
| Rate for Payer: Priority Health Medicare |
$304.03
|
| Rate for Payer: Priority Health Narrow Network |
$430.30
|
| Rate for Payer: Priority Health SBD |
$430.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$304.03
|
| Rate for Payer: UHC Exchange |
$361.90
|
| Rate for Payer: UHC Medicare Advantage |
$304.03
|
| Rate for Payer: UHCCP Medicaid |
$205.55
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 11420
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$14,285.00 |
| Rate for Payer: Aetna Commercial |
$104.45
|
| Rate for Payer: Aetna Medicare |
$81.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.25
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$77.95
|
| Rate for Payer: BCBS Trust/PPO |
$100.72
|
| Rate for Payer: BCN Commercial |
$150.39
|
| Rate for Payer: BCN Medicare Advantage |
$77.95
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$112.25
|
| Rate for Payer: Cofinity Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.95
|
| Rate for Payer: Healthscope Commercial |
$144.21
|
| Rate for Payer: Healthscope Commercial |
$124.72
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.85
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,285.00
|
| Rate for Payer: Nomi Health Commercial |
$93.54
|
| Rate for Payer: PACE SWMI |
$77.95
|
| Rate for Payer: PHP Medicare Advantage |
$77.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.97
|
| Rate for Payer: Priority Health Medicare |
$77.95
|
| Rate for Payer: Priority Health Narrow Network |
$111.97
|
| Rate for Payer: Priority Health SBD |
$111.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.95
|
| Rate for Payer: UHC Exchange |
$112.79
|
| Rate for Payer: UHC Medicare Advantage |
$77.95
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
11421
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$164.43 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna Commercial |
$221.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.65
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$182.70
|
| Rate for Payer: Cofinity Commercial |
$224.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.80
|
| Rate for Payer: Healthscope Commercial |
$234.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.85
|
| Rate for Payer: PHP Commercial |
$221.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health SBD |
$164.43
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
11421
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$19,150.00 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$107.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.51
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$103.13
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$138.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.13
|
| Rate for Payer: Healthscope Commercial |
$190.79
|
| Rate for Payer: Healthscope Commercial |
$165.01
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,150.00
|
| Rate for Payer: Nomi Health Commercial |
$123.76
|
| Rate for Payer: PACE SWMI |
$103.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.55
|
| Rate for Payer: Priority Health Medicare |
$103.13
|
| Rate for Payer: Priority Health Narrow Network |
$148.55
|
| Rate for Payer: Priority Health SBD |
$148.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.13
|
| Rate for Payer: UHC Exchange |
$143.66
|
| Rate for Payer: UHC Medicare Advantage |
$103.13
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
11421
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$114.27 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$221.85
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.65
|
| 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 |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$224.46
|
| Rate for Payer: Cofinity Commercial |
$182.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$234.90
|
| 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 |
$221.85
|
| 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 |
$221.85
|
| 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 |
$169.65
|
| 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 |
$164.43
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.27
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 11421
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$19,150.00 |
| Rate for Payer: Aetna Commercial |
$138.19
|
| Rate for Payer: Aetna Medicare |
$107.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.51
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$103.13
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$188.87
|
| Rate for Payer: BCN Medicare Advantage |
$103.13
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cofinity Commercial |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$138.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.13
|
| Rate for Payer: Healthscope Commercial |
$190.79
|
| Rate for Payer: Healthscope Commercial |
$165.01
|
| Rate for Payer: Mclaren Medicaid |
$70.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.29
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,150.00
|
| Rate for Payer: Nomi Health Commercial |
$123.76
|
| Rate for Payer: PACE SWMI |
$103.13
|
| Rate for Payer: PHP Medicare Advantage |
$103.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.55
|
| Rate for Payer: Priority Health Medicare |
$103.13
|
| Rate for Payer: Priority Health Narrow Network |
$148.55
|
| Rate for Payer: Priority Health SBD |
$148.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.13
|
| Rate for Payer: UHC Exchange |
$143.66
|
| Rate for Payer: UHC Medicare Advantage |
$103.13
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$141.90 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$247.35
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.15
|
| 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 |
$965.26
|
| Rate for Payer: BCN Commercial |
$965.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$250.26
|
| Rate for Payer: Cofinity Commercial |
$203.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$261.90
|
| 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 |
$247.35
|
| 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 |
$247.35
|
| 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 |
$189.15
|
| 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 |
$183.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.90
|
| Rate for Payer: UHC Core |
$1,463.00
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 11422
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$23,639.00 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$134.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.63
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$128.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$185.63
|
| Rate for Payer: Cofinity Commercial |
$172.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.91
|
| Rate for Payer: Healthscope Commercial |
$238.48
|
| Rate for Payer: Healthscope Commercial |
$206.26
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,639.00
|
| Rate for Payer: Nomi Health Commercial |
$154.69
|
| Rate for Payer: PACE SWMI |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$128.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.12
|
| Rate for Payer: Priority Health Medicare |
$128.91
|
| Rate for Payer: Priority Health Narrow Network |
$185.12
|
| Rate for Payer: Priority Health SBD |
$185.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.91
|
| Rate for Payer: UHC Exchange |
$161.08
|
| Rate for Payer: UHC Medicare Advantage |
$128.91
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
11422
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$23,639.00 |
| Rate for Payer: Aetna Commercial |
$172.74
|
| Rate for Payer: Aetna Medicare |
$134.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.63
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$128.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$211.65
|
| Rate for Payer: BCN Medicare Advantage |
$128.91
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$172.74
|
| Rate for Payer: Cofinity Commercial |
$185.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.91
|
| Rate for Payer: Healthscope Commercial |
$238.48
|
| Rate for Payer: Healthscope Commercial |
$206.26
|
| Rate for Payer: Mclaren Medicaid |
$88.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.36
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,639.00
|
| Rate for Payer: Nomi Health Commercial |
$154.69
|
| Rate for Payer: PACE SWMI |
$128.91
|
| Rate for Payer: PHP Medicare Advantage |
$128.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.12
|
| Rate for Payer: Priority Health Medicare |
$128.91
|
| Rate for Payer: Priority Health Narrow Network |
$185.12
|
| Rate for Payer: Priority Health SBD |
$185.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.91
|
| Rate for Payer: UHC Exchange |
$161.08
|
| Rate for Payer: UHC Medicare Advantage |
$128.91
|
| Rate for Payer: UHCCP Medicaid |
$88.40
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
11422
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$183.33 |
| Max. Negotiated Rate |
$261.90 |
| Rate for Payer: Aetna Commercial |
$247.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.15
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$250.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.80
|
| Rate for Payer: Healthscope Commercial |
$261.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.35
|
| Rate for Payer: PHP Commercial |
$247.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health SBD |
$183.33
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$164.68 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$340.85
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.65
|
| 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 |
$965.26
|
| Rate for Payer: BCN Commercial |
$965.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$344.86
|
| Rate for Payer: Cofinity Commercial |
$280.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$280.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$360.90
|
| 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 |
$340.85
|
| 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 |
$340.85
|
| 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 |
$260.65
|
| 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 |
$252.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.68
|
| 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
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Hospital Charge Code |
11423
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$27,284.00 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$156.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.06
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$150.04
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$216.06
|
| Rate for Payer: Cofinity Commercial |
$201.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.04
|
| Rate for Payer: Healthscope Commercial |
$277.57
|
| Rate for Payer: Healthscope Commercial |
$240.06
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,284.00
|
| Rate for Payer: Nomi Health Commercial |
$180.05
|
| Rate for Payer: PACE SWMI |
$150.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$150.04
|
| Rate for Payer: Priority Health Narrow Network |
$214.02
|
| Rate for Payer: Priority Health SBD |
$214.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.04
|
| Rate for Payer: UHC Exchange |
$191.16
|
| Rate for Payer: UHC Medicare Advantage |
$150.04
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Professional
|
Both
|
$401.00
|
|
|
Service Code
|
HCPCS 11423
|
| Min. Negotiated Rate |
$102.45 |
| Max. Negotiated Rate |
$27,284.00 |
| Rate for Payer: Aetna Commercial |
$201.05
|
| Rate for Payer: Aetna Medicare |
$156.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.06
|
| Rate for Payer: BCBS Complete |
$107.57
|
| Rate for Payer: BCBS MAPPO |
$150.04
|
| Rate for Payer: BCBS Trust/PPO |
$338.18
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: BCN Medicare Advantage |
$150.04
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$216.06
|
| Rate for Payer: Cofinity Commercial |
$201.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.04
|
| Rate for Payer: Healthscope Commercial |
$277.57
|
| Rate for Payer: Healthscope Commercial |
$240.06
|
| Rate for Payer: Mclaren Medicaid |
$102.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.54
|
| Rate for Payer: Meridian Medicaid |
$107.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,284.00
|
| Rate for Payer: Nomi Health Commercial |
$180.05
|
| Rate for Payer: PACE SWMI |
$150.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.02
|
| Rate for Payer: Priority Health Medicare |
$150.04
|
| Rate for Payer: Priority Health Narrow Network |
$214.02
|
| Rate for Payer: Priority Health SBD |
$214.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.04
|
| Rate for Payer: UHC Exchange |
$191.16
|
| Rate for Payer: UHC Medicare Advantage |
$150.04
|
| Rate for Payer: UHCCP Medicaid |
$102.45
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
11423
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$252.63 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Aetna Commercial |
$340.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.65
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cofinity Commercial |
$280.70
|
| Rate for Payer: Cofinity Commercial |
$344.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$280.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.80
|
| Rate for Payer: Healthscope Commercial |
$360.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.85
|
| Rate for Payer: PHP Commercial |
$340.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.65
|
| Rate for Payer: Priority Health SBD |
$252.63
|
|
|
PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM
|
Professional
|
Both
|
$513.00
|
|
|
Service Code
|
HCPCS 11424
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$31,261.00 |
| Rate for Payer: Aetna Commercial |
$232.36
|
| Rate for Payer: Aetna Medicare |
$180.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.70
|
| Rate for Payer: BCBS Complete |
$123.68
|
| Rate for Payer: BCBS MAPPO |
$173.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,640.00
|
| Rate for Payer: BCN Commercial |
$277.61
|
| Rate for Payer: BCN Medicare Advantage |
$173.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cofinity Commercial |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.40
|
| Rate for Payer: Healthscope Commercial |
$320.79
|
| Rate for Payer: Healthscope Commercial |
$277.44
|
| Rate for Payer: Mclaren Medicaid |
$117.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.07
|
| Rate for Payer: Meridian Medicaid |
$123.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,261.00
|
| Rate for Payer: Nomi Health Commercial |
$208.08
|
| Rate for Payer: PACE SWMI |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$173.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.53
|
| Rate for Payer: Priority Health Medicare |
$173.40
|
| Rate for Payer: Priority Health Narrow Network |
$246.53
|
| Rate for Payer: Priority Health SBD |
$246.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.40
|
| Rate for Payer: UHC Exchange |
$226.64
|
| Rate for Payer: UHC Medicare Advantage |
$173.40
|
| Rate for Payer: UHCCP Medicaid |
$117.79
|
|
