|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
OP
|
$827.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$521.01 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna Commercial |
$702.95
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,734.87
|
| Rate for Payer: BCN Commercial |
$1,734.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cash Price |
$661.60
|
| Rate for Payer: Cofinity Advantage |
$578.90
|
| Rate for Payer: Cofinity Commercial |
$711.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$744.30
|
| Rate for Payer: Mclaren Medicaid |
$860.68
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$702.95
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$620.25
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$702.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$521.01
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: VA VA |
$1,645.66
|
|
|
PR EXCISION MALIGNANT TUMOR MANDIBLE RADICAL
|
Professional
|
Both
|
$2,287.00
|
|
|
Service Code
|
HCPCS 21045
|
| Min. Negotiated Rate |
$676.70 |
| Max. Negotiated Rate |
$2,119.23 |
| Rate for Payer: Aetna Commercial |
$1,394.16
|
| Rate for Payer: Aetna Medicare |
$1,082.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,394.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,498.20
|
| Rate for Payer: BCBS Complete |
$710.53
|
| Rate for Payer: BCBS MAPPO |
$1,040.42
|
| Rate for Payer: BCN Commercial |
$1,800.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.42
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cash Price |
$1,829.60
|
| Rate for Payer: Cofinity Commercial |
$1,498.20
|
| Rate for Payer: Cofinity Commercial |
$1,394.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.42
|
| Rate for Payer: Healthscope Commercial |
$1,924.78
|
| Rate for Payer: Healthscope Commercial |
$1,664.67
|
| Rate for Payer: Mclaren Medicaid |
$676.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,092.44
|
| Rate for Payer: Meridian Medicaid |
$710.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,144.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,119.23
|
| Rate for Payer: Nomi Health Commercial |
$1,248.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,715.25
|
| Rate for Payer: PACE SWMI |
$1,040.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,924.37
|
| Rate for Payer: Priority Health Medicare |
$1,040.42
|
| Rate for Payer: Priority Health SBD |
$1,924.37
|
| Rate for Payer: Priority Health Tiered Network |
$1,924.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,104.15
|
| Rate for Payer: UHC Core |
$2,104.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,040.42
|
| Rate for Payer: UHC Exchange |
$2,104.15
|
| Rate for Payer: UHC Medicaid |
$676.70
|
| Rate for Payer: UHCCP Medicaid |
$676.70
|
|
|
PR EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA
|
Professional
|
Both
|
$2,837.00
|
|
|
Service Code
|
HCPCS 21034
|
| Min. Negotiated Rate |
$630.05 |
| Max. Negotiated Rate |
$2,127.75 |
| Rate for Payer: Aetna Commercial |
$1,298.90
|
| Rate for Payer: Aetna Medicare |
$1,008.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,298.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,395.84
|
| Rate for Payer: BCBS Complete |
$661.55
|
| Rate for Payer: BCBS MAPPO |
$969.33
|
| Rate for Payer: BCN Commercial |
$1,688.66
|
| Rate for Payer: BCN Medicare Advantage |
$969.33
|
| Rate for Payer: Cash Price |
$2,269.60
|
| Rate for Payer: Cash Price |
$2,269.60
|
| Rate for Payer: Cofinity Commercial |
$1,395.84
|
| Rate for Payer: Cofinity Commercial |
$1,298.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.33
|
| Rate for Payer: Healthscope Commercial |
$1,793.26
|
| Rate for Payer: Healthscope Commercial |
$1,550.93
|
| Rate for Payer: Mclaren Medicaid |
$630.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.80
|
| Rate for Payer: Meridian Medicaid |
$661.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,066.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,990.04
|
| Rate for Payer: Nomi Health Commercial |
$1,163.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,127.75
|
| Rate for Payer: PACE SWMI |
$969.33
|
| Rate for Payer: PHP Medicare Advantage |
$969.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,805.12
|
| Rate for Payer: Priority Health Medicare |
$969.33
|
| Rate for Payer: Priority Health SBD |
$1,805.12
|
| Rate for Payer: Priority Health Tiered Network |
$1,805.12
|
| Rate for Payer: Railroad Medicare Medicare |
$969.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,979.46
|
| Rate for Payer: UHC Core |
$1,979.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$969.33
|
| Rate for Payer: UHC Exchange |
$1,979.46
|
| Rate for Payer: UHC Medicaid |
$630.05
|
| Rate for Payer: UHCCP Medicaid |
$630.05
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$328.00
|
|
|
Service Code
|
HCPCS 11600
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$246.00 |
| Rate for Payer: Aetna Commercial |
$141.02
|
| Rate for Payer: Aetna Medicare |
$109.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.55
|
| Rate for Payer: BCBS Complete |
$72.69
|
| Rate for Payer: BCBS MAPPO |
$105.24
|
| Rate for Payer: BCN Commercial |
$183.76
|
| Rate for Payer: BCN Medicare Advantage |
$105.24
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cash Price |
$262.40
|
| Rate for Payer: Cofinity Commercial |
$151.55
|
| Rate for Payer: Cofinity Commercial |
$141.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.24
|
| Rate for Payer: Healthscope Commercial |
$194.69
|
| Rate for Payer: Healthscope Commercial |
$168.38
|
| Rate for Payer: Mclaren Medicaid |
$69.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.50
|
| Rate for Payer: Meridian Medicaid |
$72.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.34
|
| Rate for Payer: Nomi Health Commercial |
$126.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.00
|
| Rate for Payer: PACE SWMI |
$105.24
|
| Rate for Payer: PHP Medicare Advantage |
$105.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$168.19
|
| Rate for Payer: Priority Health Medicare |
$105.24
|
| Rate for Payer: Priority Health SBD |
$168.19
|
| Rate for Payer: Priority Health Tiered Network |
$168.19
|
| Rate for Payer: Railroad Medicare Medicare |
$105.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.61
|
| Rate for Payer: UHC Core |
$208.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$105.24
|
| Rate for Payer: UHC Exchange |
$208.61
|
| Rate for Payer: UHC Medicaid |
$69.23
|
| Rate for Payer: UHCCP Medicaid |
$69.23
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 11601
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$167.10
|
| Rate for Payer: Aetna Medicare |
$129.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.57
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$124.70
|
| Rate for Payer: BCN Commercial |
$175.93
|
| Rate for Payer: BCN Medicare Advantage |
$124.70
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$179.57
|
| Rate for Payer: Cofinity Commercial |
$167.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.70
|
| Rate for Payer: Healthscope Commercial |
$230.69
|
| Rate for Payer: Healthscope Commercial |
$199.52
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.94
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.80
|
| Rate for Payer: Nomi Health Commercial |
$149.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: PACE SWMI |
$124.70
|
| Rate for Payer: PHP Medicare Advantage |
$124.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$204.19
|
| Rate for Payer: Priority Health Medicare |
$124.70
|
| Rate for Payer: Priority Health SBD |
$204.19
|
| Rate for Payer: Priority Health Tiered Network |
$204.19
|
| Rate for Payer: Railroad Medicare Medicare |
$124.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.99
|
| Rate for Payer: UHC Core |
$255.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.70
|
| Rate for Payer: UHC Exchange |
$255.99
|
| Rate for Payer: UHC Medicaid |
$81.79
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 11602
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$316.50 |
| Rate for Payer: Aetna Commercial |
$177.97
|
| Rate for Payer: Aetna Medicare |
$138.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.25
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$132.81
|
| Rate for Payer: BCN Commercial |
$191.24
|
| Rate for Payer: BCN Medicare Advantage |
$132.81
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$191.25
|
| Rate for Payer: Cofinity Commercial |
$177.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.81
|
| Rate for Payer: Healthscope Commercial |
$245.70
|
| Rate for Payer: Healthscope Commercial |
$212.50
|
| Rate for Payer: Mclaren Medicaid |
$87.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.45
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.02
|
| Rate for Payer: Nomi Health Commercial |
$159.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| Rate for Payer: PACE SWMI |
$132.81
|
| Rate for Payer: PHP Medicare Advantage |
$132.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.97
|
| Rate for Payer: Priority Health Medicare |
$132.81
|
| Rate for Payer: Priority Health SBD |
$221.97
|
| Rate for Payer: Priority Health Tiered Network |
$221.97
|
| Rate for Payer: Railroad Medicare Medicare |
$132.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.46
|
| Rate for Payer: UHC Core |
$279.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.81
|
| Rate for Payer: UHC Exchange |
$279.46
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 11602
|
| Hospital Charge Code |
11602
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$316.50 |
| Rate for Payer: Aetna Commercial |
$177.97
|
| Rate for Payer: Aetna Medicare |
$138.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.25
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$132.81
|
| Rate for Payer: BCN Commercial |
$191.24
|
| Rate for Payer: BCN Medicare Advantage |
$132.81
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Commercial |
$191.25
|
| Rate for Payer: Cofinity Commercial |
$177.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.81
|
| Rate for Payer: Healthscope Commercial |
$245.70
|
| Rate for Payer: Healthscope Commercial |
$212.50
|
| Rate for Payer: Mclaren Medicaid |
$87.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.45
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.02
|
| Rate for Payer: Nomi Health Commercial |
$159.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| Rate for Payer: PACE SWMI |
$132.81
|
| Rate for Payer: PHP Medicare Advantage |
$132.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$221.97
|
| Rate for Payer: Priority Health Medicare |
$132.81
|
| Rate for Payer: Priority Health SBD |
$221.97
|
| Rate for Payer: Priority Health Tiered Network |
$221.97
|
| Rate for Payer: Railroad Medicare Medicare |
$132.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.46
|
| Rate for Payer: UHC Core |
$279.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.81
|
| Rate for Payer: UHC Exchange |
$279.46
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
IP
|
$422.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$265.86 |
| Max. Negotiated Rate |
$379.80 |
| Rate for Payer: Aetna Commercial |
$358.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.30
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Advantage |
$295.40
|
| Rate for Payer: Cofinity Commercial |
$362.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.60
|
| Rate for Payer: Healthscope Commercial |
$379.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| Rate for Payer: PHP Commercial |
$358.70
|
| Rate for Payer: Priority Health SBD |
$265.86
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
OP
|
$422.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna Commercial |
$358.70
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$416.69
|
| Rate for Payer: BCN Commercial |
$416.69
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cofinity Advantage |
$295.40
|
| Rate for Payer: Cofinity Commercial |
$362.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$379.80
|
| Rate for Payer: Mclaren Medicaid |
$211.84
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.70
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.50
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$358.70
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$265.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: VA VA |
$405.05
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: Aetna Medicare |
$165.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.67
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$159.49
|
| Rate for Payer: BCN Commercial |
$289.82
|
| Rate for Payer: BCN Medicare Advantage |
$159.49
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$229.67
|
| Rate for Payer: Cofinity Commercial |
$213.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.49
|
| Rate for Payer: Healthscope Commercial |
$295.06
|
| Rate for Payer: Healthscope Commercial |
$255.18
|
| Rate for Payer: Mclaren Medicaid |
$104.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.46
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.79
|
| Rate for Payer: Nomi Health Commercial |
$191.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PACE SWMI |
$159.49
|
| Rate for Payer: PHP Medicare Advantage |
$159.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$265.27
|
| Rate for Payer: Priority Health Medicare |
$159.49
|
| Rate for Payer: Priority Health SBD |
$265.27
|
| Rate for Payer: Priority Health Tiered Network |
$265.27
|
| Rate for Payer: Railroad Medicare Medicare |
$159.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.05
|
| Rate for Payer: UHC Core |
$335.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$159.49
|
| Rate for Payer: UHC Exchange |
$335.05
|
| Rate for Payer: UHC Medicaid |
$104.16
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 11603
|
| Hospital Charge Code |
11603
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: Aetna Medicare |
$165.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.67
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$159.49
|
| Rate for Payer: BCN Commercial |
$289.82
|
| Rate for Payer: BCN Medicare Advantage |
$159.49
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$229.67
|
| Rate for Payer: Cofinity Commercial |
$213.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.49
|
| Rate for Payer: Healthscope Commercial |
$295.06
|
| Rate for Payer: Healthscope Commercial |
$255.18
|
| Rate for Payer: Mclaren Medicaid |
$104.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.46
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.79
|
| Rate for Payer: Nomi Health Commercial |
$191.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PACE SWMI |
$159.49
|
| Rate for Payer: PHP Medicare Advantage |
$159.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$265.27
|
| Rate for Payer: Priority Health Medicare |
$159.49
|
| Rate for Payer: Priority Health SBD |
$265.27
|
| Rate for Payer: Priority Health Tiered Network |
$265.27
|
| Rate for Payer: Railroad Medicare Medicare |
$159.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.05
|
| Rate for Payer: UHC Core |
$335.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$159.49
|
| Rate for Payer: UHC Exchange |
$335.05
|
| Rate for Payer: UHC Medicaid |
$104.16
|
| Rate for Payer: UHCCP Medicaid |
$104.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
OP
|
$481.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$303.03 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$408.85
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$535.08
|
| Rate for Payer: BCN Commercial |
$535.08
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Advantage |
$336.70
|
| Rate for Payer: Cofinity Commercial |
$413.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$432.90
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.85
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$408.85
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$303.03
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
IP
|
$481.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$303.03 |
| Max. Negotiated Rate |
$432.90 |
| Rate for Payer: Aetna Commercial |
$408.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.65
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Advantage |
$336.70
|
| Rate for Payer: Cofinity Commercial |
$413.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.80
|
| Rate for Payer: Healthscope Commercial |
$432.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PHP Commercial |
$408.85
|
| Rate for Payer: Priority Health SBD |
$303.03
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
OP
|
$537.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$338.31 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna Commercial |
$456.45
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$847.31
|
| Rate for Payer: BCN Commercial |
$847.31
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Advantage |
$375.90
|
| Rate for Payer: Cofinity Commercial |
$461.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$483.30
|
| Rate for Payer: Mclaren Medicaid |
$369.02
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.45
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$456.45
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$338.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: VA VA |
$705.59
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
IP
|
$537.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$338.31 |
| Max. Negotiated Rate |
$483.30 |
| Rate for Payer: Aetna Commercial |
$456.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.05
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Advantage |
$375.90
|
| Rate for Payer: Cofinity Commercial |
$461.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.60
|
| Rate for Payer: Healthscope Commercial |
$483.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PHP Commercial |
$456.45
|
| Rate for Payer: Priority Health SBD |
$338.31
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 11604
|
| Hospital Charge Code |
11604
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$402.75 |
| Rate for Payer: Aetna Commercial |
$237.38
|
| Rate for Payer: Aetna Medicare |
$184.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.10
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.15
|
| Rate for Payer: BCN Commercial |
$319.21
|
| Rate for Payer: BCN Medicare Advantage |
$177.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$255.10
|
| Rate for Payer: Cofinity Commercial |
$237.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.15
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Healthscope Commercial |
$283.44
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.01
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.64
|
| Rate for Payer: Nomi Health Commercial |
$212.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$177.15
|
| Rate for Payer: PHP Medicare Advantage |
$177.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$292.15
|
| Rate for Payer: Priority Health Medicare |
$177.15
|
| Rate for Payer: Priority Health SBD |
$292.15
|
| Rate for Payer: Priority Health Tiered Network |
$292.15
|
| Rate for Payer: Railroad Medicare Medicare |
$177.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.72
|
| Rate for Payer: UHC Core |
$370.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.15
|
| Rate for Payer: UHC Exchange |
$370.72
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 11604
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$402.75 |
| Rate for Payer: PHP Medicare Advantage |
$177.15
|
| Rate for Payer: Aetna Commercial |
$237.38
|
| Rate for Payer: Aetna Medicare |
$184.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.10
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCBS MAPPO |
$177.15
|
| Rate for Payer: BCN Commercial |
$319.21
|
| Rate for Payer: BCN Medicare Advantage |
$177.15
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$255.10
|
| Rate for Payer: Cofinity Commercial |
$237.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.15
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Healthscope Commercial |
$283.44
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.01
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.64
|
| Rate for Payer: Nomi Health Commercial |
$212.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$177.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$292.15
|
| Rate for Payer: Priority Health Medicare |
$177.15
|
| Rate for Payer: Priority Health SBD |
$292.15
|
| Rate for Payer: Priority Health Tiered Network |
$292.15
|
| Rate for Payer: Railroad Medicare Medicare |
$177.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.72
|
| Rate for Payer: UHC Core |
$370.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$177.15
|
| Rate for Payer: UHC Exchange |
$370.72
|
| Rate for Payer: UHC Medicaid |
$115.45
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
PR EXCISION MAXILLARY TORUS PALATINUS
|
Professional
|
Both
|
$817.00
|
|
|
Service Code
|
HCPCS 21032
|
| Min. Negotiated Rate |
$155.70 |
| Max. Negotiated Rate |
$612.75 |
| Rate for Payer: Aetna Commercial |
$315.56
|
| Rate for Payer: Aetna Medicare |
$244.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$339.11
|
| Rate for Payer: BCBS Complete |
$163.49
|
| Rate for Payer: BCBS MAPPO |
$235.49
|
| Rate for Payer: BCN Commercial |
$397.38
|
| Rate for Payer: BCN Medicare Advantage |
$235.49
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cash Price |
$653.60
|
| Rate for Payer: Cofinity Commercial |
$339.11
|
| Rate for Payer: Cofinity Commercial |
$315.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.49
|
| Rate for Payer: Healthscope Commercial |
$435.66
|
| Rate for Payer: Healthscope Commercial |
$376.78
|
| Rate for Payer: Mclaren Medicaid |
$155.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.26
|
| Rate for Payer: Meridian Medicaid |
$163.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.77
|
| Rate for Payer: Nomi Health Commercial |
$282.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$612.75
|
| Rate for Payer: PACE SWMI |
$235.49
|
| Rate for Payer: PHP Medicare Advantage |
$235.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$424.81
|
| Rate for Payer: Priority Health Medicare |
$235.49
|
| Rate for Payer: Priority Health SBD |
$424.81
|
| Rate for Payer: Priority Health Tiered Network |
$424.81
|
| Rate for Payer: Railroad Medicare Medicare |
$235.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.29
|
| Rate for Payer: UHC Core |
$472.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$235.49
|
| Rate for Payer: UHC Exchange |
$472.29
|
| Rate for Payer: UHC Medicaid |
$155.70
|
| Rate for Payer: UHCCP Medicaid |
$155.70
|
|
|
PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS 46230
|
| Min. Negotiated Rate |
$106.07 |
| Max. Negotiated Rate |
$524.25 |
| Rate for Payer: Aetna Commercial |
$218.07
|
| Rate for Payer: Aetna Medicare |
$169.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.35
|
| Rate for Payer: BCBS Complete |
$111.37
|
| Rate for Payer: BCBS MAPPO |
$162.74
|
| Rate for Payer: BCN Commercial |
$263.44
|
| Rate for Payer: BCN Medicare Advantage |
$162.74
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$234.35
|
| Rate for Payer: Cofinity Commercial |
$218.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.74
|
| Rate for Payer: Healthscope Commercial |
$301.07
|
| Rate for Payer: Healthscope Commercial |
$260.38
|
| Rate for Payer: Mclaren Medicaid |
$106.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.88
|
| Rate for Payer: Meridian Medicaid |
$111.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.50
|
| Rate for Payer: Nomi Health Commercial |
$195.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$524.25
|
| Rate for Payer: PACE SWMI |
$162.74
|
| Rate for Payer: PHP Medicare Advantage |
$162.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$320.97
|
| Rate for Payer: Priority Health Medicare |
$162.74
|
| Rate for Payer: Priority Health SBD |
$320.97
|
| Rate for Payer: Priority Health Tiered Network |
$320.97
|
| Rate for Payer: Railroad Medicare Medicare |
$162.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.70
|
| Rate for Payer: UHC Core |
$303.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.74
|
| Rate for Payer: UHC Exchange |
$303.70
|
| Rate for Payer: UHC Medicaid |
$106.07
|
| Rate for Payer: UHCCP Medicaid |
$106.07
|
|
|
PR EXCISION NAIL&NAIL MATRIX PRTL/COMPL PERM RMVL
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 11750
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$372.75 |
| Rate for Payer: Aetna Commercial |
$122.58
|
| Rate for Payer: Aetna Medicare |
$95.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.73
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$91.48
|
| Rate for Payer: BCN Commercial |
$120.56
|
| Rate for Payer: BCN Medicare Advantage |
$91.48
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$131.73
|
| Rate for Payer: Cofinity Commercial |
$122.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.48
|
| Rate for Payer: Healthscope Commercial |
$169.24
|
| Rate for Payer: Healthscope Commercial |
$146.37
|
| Rate for Payer: Mclaren Medicaid |
$60.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.05
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.93
|
| Rate for Payer: Nomi Health Commercial |
$109.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.75
|
| Rate for Payer: PACE SWMI |
$91.48
|
| Rate for Payer: PHP Medicare Advantage |
$91.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$139.92
|
| Rate for Payer: Priority Health Medicare |
$91.48
|
| Rate for Payer: Priority Health SBD |
$139.92
|
| Rate for Payer: Priority Health Tiered Network |
$139.92
|
| Rate for Payer: Railroad Medicare Medicare |
$91.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.26
|
| Rate for Payer: UHC Core |
$176.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.48
|
| Rate for Payer: UHC Exchange |
$176.26
|
| Rate for Payer: UHC Medicaid |
$60.07
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
|
|
PR EXCISION NASAL POLYP EXTENSIVE
|
Professional
|
Both
|
$837.00
|
|
|
Service Code
|
HCPCS 30115
|
| Min. Negotiated Rate |
$276.47 |
| Max. Negotiated Rate |
$819.72 |
| Rate for Payer: Aetna Commercial |
$553.26
|
| Rate for Payer: Aetna Medicare |
$429.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$594.55
|
| Rate for Payer: BCBS Complete |
$290.29
|
| Rate for Payer: BCBS MAPPO |
$412.88
|
| Rate for Payer: BCN Commercial |
$697.67
|
| Rate for Payer: BCN Medicare Advantage |
$412.88
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cash Price |
$669.60
|
| Rate for Payer: Cofinity Commercial |
$594.55
|
| Rate for Payer: Cofinity Commercial |
$553.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.88
|
| Rate for Payer: Healthscope Commercial |
$763.83
|
| Rate for Payer: Healthscope Commercial |
$660.61
|
| Rate for Payer: Mclaren Medicaid |
$276.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.52
|
| Rate for Payer: Meridian Medicaid |
$290.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$454.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$819.72
|
| Rate for Payer: Nomi Health Commercial |
$495.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$627.75
|
| Rate for Payer: PACE SWMI |
$412.88
|
| Rate for Payer: PHP Medicare Advantage |
$412.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$656.99
|
| Rate for Payer: Priority Health Medicare |
$412.88
|
| Rate for Payer: Priority Health SBD |
$656.99
|
| Rate for Payer: Priority Health Tiered Network |
$656.99
|
| Rate for Payer: Railroad Medicare Medicare |
$412.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$756.59
|
| Rate for Payer: UHC Core |
$756.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.88
|
| Rate for Payer: UHC Exchange |
$756.59
|
| Rate for Payer: UHC Medicaid |
$276.47
|
| Rate for Payer: UHCCP Medicaid |
$276.47
|
|
|
PR EXCISION NASAL POLYP SIMPLE
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 30110
|
| Min. Negotiated Rate |
$76.47 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$155.31
|
| Rate for Payer: Aetna Medicare |
$120.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.90
|
| Rate for Payer: BCBS Complete |
$80.29
|
| Rate for Payer: BCBS MAPPO |
$115.90
|
| Rate for Payer: BCN Commercial |
$201.68
|
| Rate for Payer: BCN Medicare Advantage |
$115.90
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Cofinity Commercial |
$166.90
|
| Rate for Payer: Cofinity Commercial |
$155.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.90
|
| Rate for Payer: Healthscope Commercial |
$214.41
|
| Rate for Payer: Healthscope Commercial |
$185.44
|
| Rate for Payer: Mclaren Medicaid |
$76.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.69
|
| Rate for Payer: Meridian Medicaid |
$80.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.60
|
| Rate for Payer: Nomi Health Commercial |
$139.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.00
|
| Rate for Payer: PACE SWMI |
$115.90
|
| Rate for Payer: PHP Medicare Advantage |
$115.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.92
|
| Rate for Payer: Priority Health Medicare |
$115.90
|
| Rate for Payer: Priority Health SBD |
$189.92
|
| Rate for Payer: Priority Health Tiered Network |
$189.92
|
| Rate for Payer: Railroad Medicare Medicare |
$115.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.82
|
| Rate for Payer: UHC Core |
$222.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.90
|
| Rate for Payer: UHC Exchange |
$222.82
|
| Rate for Payer: UHC Medicaid |
$76.47
|
| Rate for Payer: UHCCP Medicaid |
$76.47
|
|
|
PR EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT
|
Professional
|
Both
|
$343.00
|
|
|
Service Code
|
HCPCS 64778
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$323.83 |
| Rate for Payer: Aetna Commercial |
$207.59
|
| Rate for Payer: Aetna Medicare |
$161.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.08
|
| Rate for Payer: BCBS Complete |
$103.77
|
| Rate for Payer: BCBS MAPPO |
$154.92
|
| Rate for Payer: BCN Commercial |
$267.91
|
| Rate for Payer: BCN Medicare Advantage |
$154.92
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cash Price |
$274.40
|
| Rate for Payer: Cofinity Commercial |
$223.08
|
| Rate for Payer: Cofinity Commercial |
$207.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.92
|
| Rate for Payer: Healthscope Commercial |
$286.60
|
| Rate for Payer: Healthscope Commercial |
$247.87
|
| Rate for Payer: Mclaren Medicaid |
$98.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.67
|
| Rate for Payer: Meridian Medicaid |
$103.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.17
|
| Rate for Payer: Nomi Health Commercial |
$185.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.25
|
| Rate for Payer: PACE SWMI |
$154.92
|
| Rate for Payer: PHP Medicare Advantage |
$154.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$311.17
|
| Rate for Payer: Priority Health Medicare |
$154.92
|
| Rate for Payer: Priority Health SBD |
$311.17
|
| Rate for Payer: Priority Health Tiered Network |
$311.17
|
| Rate for Payer: Railroad Medicare Medicare |
$154.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.83
|
| Rate for Payer: UHC Core |
$323.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$154.92
|
| Rate for Payer: UHC Exchange |
$323.83
|
| Rate for Payer: UHC Medicaid |
$98.83
|
| Rate for Payer: UHCCP Medicaid |
$98.83
|
|
|
PR EXCISION NEUROMA SCIATIC NERVE
|
Professional
|
Both
|
$3,654.00
|
|
|
Service Code
|
HCPCS 64786
|
| Min. Negotiated Rate |
$606.62 |
| Max. Negotiated Rate |
$2,740.50 |
| Rate for Payer: PHP Medicare Advantage |
$945.05
|
| Rate for Payer: Aetna Commercial |
$1,266.37
|
| Rate for Payer: Aetna Medicare |
$982.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,266.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,360.87
|
| Rate for Payer: BCBS Complete |
$636.95
|
| Rate for Payer: BCBS MAPPO |
$945.05
|
| Rate for Payer: BCN Commercial |
$1,514.86
|
| Rate for Payer: BCN Medicare Advantage |
$945.05
|
| Rate for Payer: Cash Price |
$2,923.20
|
| Rate for Payer: Cash Price |
$2,923.20
|
| Rate for Payer: Cofinity Commercial |
$1,360.87
|
| Rate for Payer: Cofinity Commercial |
$1,266.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.05
|
| Rate for Payer: Healthscope Commercial |
$1,748.34
|
| Rate for Payer: Healthscope Commercial |
$1,512.08
|
| Rate for Payer: Mclaren Medicaid |
$606.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$992.30
|
| Rate for Payer: Meridian Medicaid |
$636.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,801.22
|
| Rate for Payer: Nomi Health Commercial |
$1,134.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,740.50
|
| Rate for Payer: PACE SWMI |
$945.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$606.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,759.48
|
| Rate for Payer: Priority Health Medicare |
$945.05
|
| Rate for Payer: Priority Health SBD |
$1,759.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,759.48
|
| Rate for Payer: Railroad Medicare Medicare |
$945.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,786.46
|
| Rate for Payer: UHC Core |
$1,786.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$945.05
|
| Rate for Payer: UHC Exchange |
$1,786.46
|
| Rate for Payer: UHC Medicaid |
$606.62
|
| Rate for Payer: UHCCP Medicaid |
$606.62
|
|
|
PR EXCISION OF BULBOURETHRAL GLAND
|
Professional
|
Both
|
$1,171.00
|
|
|
Service Code
|
HCPCS 53250
|
| Min. Negotiated Rate |
$234.30 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$482.19
|
| Rate for Payer: Aetna Medicare |
$374.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$518.17
|
| Rate for Payer: BCBS Complete |
$246.01
|
| Rate for Payer: BCBS MAPPO |
$359.84
|
| Rate for Payer: BCN Commercial |
$599.07
|
| Rate for Payer: BCN Medicare Advantage |
$359.84
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cofinity Commercial |
$518.17
|
| Rate for Payer: Cofinity Commercial |
$482.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.84
|
| Rate for Payer: Healthscope Commercial |
$665.70
|
| Rate for Payer: Healthscope Commercial |
$575.74
|
| Rate for Payer: Mclaren Medicaid |
$234.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.83
|
| Rate for Payer: Meridian Medicaid |
$246.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$696.17
|
| Rate for Payer: Nomi Health Commercial |
$431.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$878.25
|
| Rate for Payer: PACE SWMI |
$359.84
|
| Rate for Payer: PHP Medicare Advantage |
$359.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$652.59
|
| Rate for Payer: Priority Health Medicare |
$359.84
|
| Rate for Payer: Priority Health SBD |
$652.59
|
| Rate for Payer: Priority Health Tiered Network |
$652.59
|
| Rate for Payer: Railroad Medicare Medicare |
$359.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.99
|
| Rate for Payer: UHC Core |
$694.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$359.84
|
| Rate for Payer: UHC Exchange |
$694.99
|
| Rate for Payer: UHC Medicaid |
$234.30
|
| Rate for Payer: UHCCP Medicaid |
$234.30
|
|
