|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Facility
|
OP
|
$595.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
11624
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$374.85 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$505.75
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$416.50
|
| Rate for Payer: Cofinity Commercial |
$511.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$416.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.75
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$505.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$374.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 11624
|
| Hospital Charge Code |
11624
|
| Min. Negotiated Rate |
$225.44 |
| Max. Negotiated Rate |
$417.06 |
| Rate for Payer: Aetna Commercial |
$302.09
|
| Rate for Payer: Aetna Medicare |
$234.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.63
|
| Rate for Payer: BCBS Complete |
$238.00
|
| Rate for Payer: BCBS MAPPO |
$225.44
|
| Rate for Payer: BCN Medicare Advantage |
$225.44
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$324.63
|
| Rate for Payer: Cofinity Commercial |
$302.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.44
|
| Rate for Payer: Healthscope Commercial |
$360.70
|
| Rate for Payer: Healthscope Commercial |
$417.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$386.75
|
| Rate for Payer: Nomi Health Commercial |
$270.53
|
| Rate for Payer: PACE SWMI |
$225.44
|
| Rate for Payer: PHP Medicare Advantage |
$225.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.75
|
| Rate for Payer: Priority Health Medicare |
$225.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.44
|
| Rate for Payer: UHC Medicare Advantage |
$225.44
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
IP
|
$930.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$585.90 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Aetna Commercial |
$790.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.50
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$651.00
|
| Rate for Payer: Cofinity Commercial |
$799.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$651.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.00
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.50
|
| Rate for Payer: PHP Commercial |
$790.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health SBD |
$585.90
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Facility
|
OP
|
$930.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
11626
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$585.90 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna Commercial |
$790.50
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$799.80
|
| Rate for Payer: Cofinity Commercial |
$651.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$651.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.50
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$790.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$585.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,571.50
|
| Rate for Payer: VA VA |
$2,791.30
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$277.64 |
| Max. Negotiated Rate |
$604.50 |
| Rate for Payer: Aetna Commercial |
$372.04
|
| Rate for Payer: Aetna Medicare |
$288.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.04
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCN Medicare Advantage |
$277.64
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$399.80
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.64
|
| Rate for Payer: Healthscope Commercial |
$444.22
|
| Rate for Payer: Healthscope Commercial |
$513.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.50
|
| Rate for Payer: Nomi Health Commercial |
$333.17
|
| Rate for Payer: PACE SWMI |
$277.64
|
| Rate for Payer: PHP Medicare Advantage |
$277.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
|
|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Hospital Charge Code |
11626
|
| Min. Negotiated Rate |
$277.64 |
| Max. Negotiated Rate |
$604.50 |
| Rate for Payer: Aetna Commercial |
$372.04
|
| Rate for Payer: Aetna Medicare |
$288.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.80
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCN Medicare Advantage |
$277.64
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$372.04
|
| Rate for Payer: Cofinity Commercial |
$399.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.64
|
| Rate for Payer: Healthscope Commercial |
$513.63
|
| Rate for Payer: Healthscope Commercial |
$444.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.50
|
| Rate for Payer: Nomi Health Commercial |
$333.17
|
| Rate for Payer: PACE SWMI |
$277.64
|
| Rate for Payer: PHP Medicare Advantage |
$277.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Hospital Charge Code |
11606
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$557.96 |
| Rate for Payer: Aetna Commercial |
$404.14
|
| Rate for Payer: Aetna Medicare |
$313.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.30
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCN Medicare Advantage |
$301.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$404.14
|
| Rate for Payer: Cofinity Commercial |
$434.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.60
|
| Rate for Payer: Healthscope Commercial |
$557.96
|
| Rate for Payer: Healthscope Commercial |
$482.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.95
|
| Rate for Payer: Nomi Health Commercial |
$361.92
|
| Rate for Payer: PACE SWMI |
$301.60
|
| Rate for Payer: PHP Medicare Advantage |
$301.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Min. Negotiated Rate |
$301.60 |
| Max. Negotiated Rate |
$557.96 |
| Rate for Payer: Aetna Commercial |
$404.14
|
| Rate for Payer: Aetna Medicare |
$313.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.14
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCN Medicare Advantage |
$301.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$434.30
|
| Rate for Payer: Cofinity Commercial |
$404.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.60
|
| Rate for Payer: Healthscope Commercial |
$557.96
|
| Rate for Payer: Healthscope Commercial |
$482.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.95
|
| Rate for Payer: Nomi Health Commercial |
$361.92
|
| Rate for Payer: PACE SWMI |
$301.60
|
| Rate for Payer: PHP Medicare Advantage |
$301.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$505.89 |
| Max. Negotiated Rate |
$722.70 |
| Rate for Payer: Aetna Commercial |
$682.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.95
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$562.10
|
| Rate for Payer: Cofinity Commercial |
$690.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.40
|
| Rate for Payer: Healthscope Commercial |
$722.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.55
|
| Rate for Payer: PHP Commercial |
$682.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health SBD |
$505.89
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
11606
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$505.89 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna Commercial |
$682.55
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$690.58
|
| Rate for Payer: Cofinity Commercial |
$562.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$562.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$642.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$722.70
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.55
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$682.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$505.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$889.65
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
PR EXCISION MALIGNANT TUMOR MANDIBLE RADICAL
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 21045
|
| Min. Negotiated Rate |
$888.00 |
| Max. Negotiated Rate |
$2,108.85 |
| Rate for Payer: Aetna Commercial |
$1,527.49
|
| Rate for Payer: Aetna Medicare |
$1,185.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,527.49
|
| Rate for Payer: BCBS Complete |
$888.00
|
| Rate for Payer: BCBS MAPPO |
$1,139.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.92
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cash Price |
$1,776.00
|
| Rate for Payer: Cofinity Commercial |
$1,641.48
|
| Rate for Payer: Cofinity Commercial |
$1,527.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.92
|
| Rate for Payer: Healthscope Commercial |
$1,823.87
|
| Rate for Payer: Healthscope Commercial |
$2,108.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,443.00
|
| Rate for Payer: Nomi Health Commercial |
$1,367.90
|
| Rate for Payer: PACE SWMI |
$1,139.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health Medicare |
$1,139.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.92
|
|
|
PR EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 21034
|
| Min. Negotiated Rate |
$1,069.88 |
| Max. Negotiated Rate |
$1,979.28 |
| Rate for Payer: Aetna Commercial |
$1,433.64
|
| Rate for Payer: Aetna Medicare |
$1,112.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.64
|
| Rate for Payer: BCBS Complete |
$1,101.60
|
| Rate for Payer: BCBS MAPPO |
$1,069.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.88
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,540.63
|
| Rate for Payer: Cofinity Commercial |
$1,433.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.88
|
| Rate for Payer: Healthscope Commercial |
$1,979.28
|
| Rate for Payer: Healthscope Commercial |
$1,711.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.10
|
| Rate for Payer: Nomi Health Commercial |
$1,283.86
|
| Rate for Payer: PACE SWMI |
$1,069.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
| Rate for Payer: Priority Health Medicare |
$1,069.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.88
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 11600
|
| Min. Negotiated Rate |
$115.21 |
| Max. Negotiated Rate |
$213.14 |
| Rate for Payer: Aetna Commercial |
$154.38
|
| Rate for Payer: Aetna Medicare |
$119.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.38
|
| Rate for Payer: BCBS Complete |
$127.20
|
| Rate for Payer: BCBS MAPPO |
$115.21
|
| Rate for Payer: BCN Medicare Advantage |
$115.21
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$165.90
|
| Rate for Payer: Cofinity Commercial |
$154.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.21
|
| Rate for Payer: Healthscope Commercial |
$184.34
|
| Rate for Payer: Healthscope Commercial |
$213.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.70
|
| Rate for Payer: Nomi Health Commercial |
$138.25
|
| Rate for Payer: PACE SWMI |
$115.21
|
| Rate for Payer: PHP Medicare Advantage |
$115.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health Medicare |
$115.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.21
|
| Rate for Payer: UHC Medicare Advantage |
$115.21
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 11601
|
| Min. Negotiated Rate |
$140.09 |
| Max. Negotiated Rate |
$259.17 |
| Rate for Payer: Aetna Commercial |
$187.72
|
| Rate for Payer: Aetna Medicare |
$145.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.72
|
| Rate for Payer: BCBS Complete |
$150.80
|
| Rate for Payer: BCBS MAPPO |
$140.09
|
| Rate for Payer: BCN Medicare Advantage |
$140.09
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$201.73
|
| Rate for Payer: Cofinity Commercial |
$187.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.09
|
| Rate for Payer: Healthscope Commercial |
$259.17
|
| Rate for Payer: Healthscope Commercial |
$224.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$245.05
|
| Rate for Payer: Nomi Health Commercial |
$168.11
|
| Rate for Payer: PACE SWMI |
$140.09
|
| Rate for Payer: PHP Medicare Advantage |
$140.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health Medicare |
$140.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.09
|
| Rate for Payer: UHC Medicare Advantage |
$140.09
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$258.30 |
| Max. Negotiated Rate |
$369.00 |
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.50
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$287.00
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$287.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health SBD |
$258.30
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 11602
|
| Hospital Charge Code |
11602
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$281.50 |
| Rate for Payer: Aetna Commercial |
$203.89
|
| Rate for Payer: Aetna Medicare |
$158.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.11
|
| Rate for Payer: BCBS Complete |
$164.00
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCN Medicare Advantage |
$152.16
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$203.89
|
| Rate for Payer: Cofinity Commercial |
$219.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.16
|
| Rate for Payer: Healthscope Commercial |
$281.50
|
| Rate for Payer: Healthscope Commercial |
$243.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.50
|
| Rate for Payer: Nomi Health Commercial |
$182.59
|
| Rate for Payer: PACE SWMI |
$152.16
|
| Rate for Payer: PHP Medicare Advantage |
$152.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
11602
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$352.60
|
| Rate for Payer: Cofinity Commercial |
$287.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$287.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$258.30
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 11602
|
| Min. Negotiated Rate |
$152.16 |
| Max. Negotiated Rate |
$281.50 |
| Rate for Payer: Aetna Commercial |
$203.89
|
| Rate for Payer: Aetna Medicare |
$158.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.89
|
| Rate for Payer: BCBS Complete |
$164.00
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCN Medicare Advantage |
$152.16
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$219.11
|
| Rate for Payer: Cofinity Commercial |
$203.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.16
|
| Rate for Payer: Healthscope Commercial |
$243.46
|
| Rate for Payer: Healthscope Commercial |
$281.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.50
|
| Rate for Payer: Nomi Health Commercial |
$182.59
|
| Rate for Payer: PACE SWMI |
$152.16
|
| Rate for Payer: PHP Medicare Advantage |
$152.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$182.50 |
| Max. Negotiated Rate |
$337.62 |
| Rate for Payer: Aetna Commercial |
$244.55
|
| Rate for Payer: Aetna Medicare |
$189.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.55
|
| Rate for Payer: BCBS Complete |
$186.80
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCN Medicare Advantage |
$182.50
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$262.80
|
| Rate for Payer: Cofinity Commercial |
$244.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.50
|
| Rate for Payer: Healthscope Commercial |
$337.62
|
| Rate for Payer: Healthscope Commercial |
$292.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.55
|
| Rate for Payer: Nomi Health Commercial |
$219.00
|
| Rate for Payer: PACE SWMI |
$182.50
|
| Rate for Payer: PHP Medicare Advantage |
$182.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$294.21 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna Commercial |
$396.95
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$326.90
|
| Rate for Payer: Cofinity Commercial |
$401.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$326.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$373.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$420.30
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$396.95
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$396.95
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$294.21
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$386.33
|
| Rate for Payer: VA VA |
$686.20
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
11603
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$294.21 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Aetna Commercial |
$396.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.55
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$326.90
|
| Rate for Payer: Cofinity Commercial |
$401.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$326.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$373.60
|
| Rate for Payer: Healthscope Commercial |
$420.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$396.95
|
| Rate for Payer: PHP Commercial |
$396.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health SBD |
$294.21
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 11603
|
| Hospital Charge Code |
11603
|
| Min. Negotiated Rate |
$182.50 |
| Max. Negotiated Rate |
$337.62 |
| Rate for Payer: Aetna Commercial |
$244.55
|
| Rate for Payer: Aetna Medicare |
$189.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.80
|
| Rate for Payer: BCBS Complete |
$186.80
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCN Medicare Advantage |
$182.50
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$262.80
|
| Rate for Payer: Cofinity Commercial |
$244.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.50
|
| Rate for Payer: Healthscope Commercial |
$292.00
|
| Rate for Payer: Healthscope Commercial |
$337.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.55
|
| Rate for Payer: Nomi Health Commercial |
$219.00
|
| Rate for Payer: PACE SWMI |
$182.50
|
| Rate for Payer: PHP Medicare Advantage |
$182.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 11604
|
| Min. Negotiated Rate |
$201.66 |
| Max. Negotiated Rate |
$373.07 |
| Rate for Payer: Aetna Commercial |
$270.22
|
| Rate for Payer: Aetna Medicare |
$209.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.22
|
| Rate for Payer: BCBS Complete |
$208.40
|
| Rate for Payer: BCBS MAPPO |
$201.66
|
| Rate for Payer: BCN Medicare Advantage |
$201.66
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$290.39
|
| Rate for Payer: Cofinity Commercial |
$270.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.66
|
| Rate for Payer: Healthscope Commercial |
$322.66
|
| Rate for Payer: Healthscope Commercial |
$373.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.65
|
| Rate for Payer: Nomi Health Commercial |
$241.99
|
| Rate for Payer: PACE SWMI |
$201.66
|
| Rate for Payer: PHP Medicare Advantage |
$201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.66
|
| Rate for Payer: UHC Medicare Advantage |
$201.66
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 11604
|
| Hospital Charge Code |
11604
|
| Min. Negotiated Rate |
$201.66 |
| Max. Negotiated Rate |
$373.07 |
| Rate for Payer: Aetna Commercial |
$270.22
|
| Rate for Payer: Aetna Medicare |
$209.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: BCBS Complete |
$208.40
|
| Rate for Payer: BCBS MAPPO |
$201.66
|
| Rate for Payer: BCN Medicare Advantage |
$201.66
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$290.39
|
| Rate for Payer: Cofinity Commercial |
$270.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.66
|
| Rate for Payer: Healthscope Commercial |
$322.66
|
| Rate for Payer: Healthscope Commercial |
$373.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.65
|
| Rate for Payer: Nomi Health Commercial |
$241.99
|
| Rate for Payer: PACE SWMI |
$201.66
|
| Rate for Payer: PHP Medicare Advantage |
$201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.66
|
| Rate for Payer: UHC Medicare Advantage |
$201.66
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
IP
|
$521.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$328.23 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna Commercial |
$442.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.65
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$364.70
|
| Rate for Payer: Cofinity Commercial |
$448.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.80
|
| Rate for Payer: Healthscope Commercial |
$468.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.85
|
| Rate for Payer: PHP Commercial |
$442.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health SBD |
$328.23
|
|
