|
PR EXCISION LACTIFEROUS DUCT FISTULA
|
Professional
|
Both
|
$794.00
|
|
|
Service Code
|
HCPCS 19112
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$56,869.00 |
| Rate for Payer: Aetna Commercial |
$417.53
|
| Rate for Payer: Aetna Medicare |
$324.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$417.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.69
|
| Rate for Payer: BCBS Complete |
$221.86
|
| Rate for Payer: BCBS MAPPO |
$311.59
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$678.77
|
| Rate for Payer: BCN Medicare Advantage |
$311.59
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cash Price |
$635.20
|
| Rate for Payer: Cofinity Commercial |
$448.69
|
| Rate for Payer: Cofinity Commercial |
$417.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.59
|
| Rate for Payer: Healthscope Commercial |
$576.44
|
| Rate for Payer: Healthscope Commercial |
$498.54
|
| Rate for Payer: Mclaren Medicaid |
$211.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.17
|
| Rate for Payer: Meridian Medicaid |
$221.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,869.00
|
| Rate for Payer: Nomi Health Commercial |
$373.91
|
| Rate for Payer: PACE SWMI |
$311.59
|
| Rate for Payer: PHP Medicare Advantage |
$311.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$516.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$443.39
|
| Rate for Payer: Priority Health Medicare |
$311.59
|
| Rate for Payer: Priority Health Narrow Network |
$443.39
|
| Rate for Payer: Priority Health SBD |
$443.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.59
|
| Rate for Payer: UHC Exchange |
$519.51
|
| Rate for Payer: UHC Medicare Advantage |
$311.59
|
| Rate for Payer: UHCCP Medicaid |
$211.30
|
|
|
PR EXCISION LESION FLOOR MOUTH
|
Professional
|
Both
|
$588.00
|
|
|
Service Code
|
HCPCS 41116
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$37,719.00 |
| Rate for Payer: Aetna Commercial |
$273.40
|
| Rate for Payer: Aetna Medicare |
$212.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.80
|
| Rate for Payer: BCBS Complete |
$147.16
|
| Rate for Payer: BCBS MAPPO |
$204.03
|
| Rate for Payer: BCBS Trust/PPO |
$916.07
|
| Rate for Payer: BCN Commercial |
$494.05
|
| Rate for Payer: BCN Medicare Advantage |
$204.03
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cash Price |
$470.40
|
| Rate for Payer: Cofinity Commercial |
$293.80
|
| Rate for Payer: Cofinity Commercial |
$273.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.03
|
| Rate for Payer: Healthscope Commercial |
$377.46
|
| Rate for Payer: Healthscope Commercial |
$326.45
|
| Rate for Payer: Mclaren Medicaid |
$140.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.23
|
| Rate for Payer: Meridian Medicaid |
$147.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,719.00
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: PACE SWMI |
$204.03
|
| Rate for Payer: PHP Medicare Advantage |
$204.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$382.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.17
|
| Rate for Payer: Priority Health Medicare |
$204.03
|
| Rate for Payer: Priority Health Narrow Network |
$390.17
|
| Rate for Payer: Priority Health SBD |
$390.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.03
|
| Rate for Payer: UHC Exchange |
$281.62
|
| Rate for Payer: UHC Medicare Advantage |
$204.03
|
| Rate for Payer: UHCCP Medicaid |
$140.15
|
|
|
PR EXCISION LESION MENISCUS/CAPSULE KNEE
|
Professional
|
Both
|
$2,340.00
|
|
|
Service Code
|
HCPCS 27347
|
| Min. Negotiated Rate |
$347.19 |
| Max. Negotiated Rate |
$93,780.00 |
| Rate for Payer: Aetna Commercial |
$684.93
|
| Rate for Payer: Aetna Medicare |
$531.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.04
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$511.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.67
|
| Rate for Payer: BCN Commercial |
$780.90
|
| Rate for Payer: BCN Medicare Advantage |
$511.14
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cash Price |
$1,872.00
|
| Rate for Payer: Cofinity Commercial |
$736.04
|
| Rate for Payer: Cofinity Commercial |
$684.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.14
|
| Rate for Payer: Healthscope Commercial |
$945.61
|
| Rate for Payer: Healthscope Commercial |
$817.82
|
| Rate for Payer: Mclaren Medicaid |
$347.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.70
|
| Rate for Payer: Meridian Medicaid |
$364.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93,780.00
|
| Rate for Payer: Nomi Health Commercial |
$613.37
|
| Rate for Payer: PACE SWMI |
$511.14
|
| Rate for Payer: PHP Medicare Advantage |
$511.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,521.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$821.30
|
| Rate for Payer: Priority Health Medicare |
$511.14
|
| Rate for Payer: Priority Health Narrow Network |
$821.30
|
| Rate for Payer: Priority Health SBD |
$821.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.14
|
| Rate for Payer: UHC Exchange |
$356.04
|
| Rate for Payer: UHC Medicare Advantage |
$511.14
|
| Rate for Payer: UHCCP Medicaid |
$347.19
|
|
|
PR EXCISION LESION MESENTERY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,508.00
|
|
|
Service Code
|
HCPCS 44820
|
| Min. Negotiated Rate |
$295.85 |
| Max. Negotiated Rate |
$152,503.00 |
| Rate for Payer: Aetna Commercial |
$1,110.95
|
| Rate for Payer: Aetna Medicare |
$862.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,110.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,193.86
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS MAPPO |
$829.07
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$1,245.15
|
| Rate for Payer: BCN Medicare Advantage |
$829.07
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cash Price |
$1,206.40
|
| Rate for Payer: Cofinity Commercial |
$1,193.86
|
| Rate for Payer: Cofinity Commercial |
$1,110.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.07
|
| Rate for Payer: Healthscope Commercial |
$1,533.78
|
| Rate for Payer: Healthscope Commercial |
$1,326.51
|
| Rate for Payer: Mclaren Medicaid |
$549.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.52
|
| Rate for Payer: Meridian Medicaid |
$576.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152,503.00
|
| Rate for Payer: Nomi Health Commercial |
$994.88
|
| Rate for Payer: PACE SWMI |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$829.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$980.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,529.66
|
| Rate for Payer: Priority Health Medicare |
$829.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.66
|
| Rate for Payer: Priority Health SBD |
$1,529.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$801.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$829.07
|
| Rate for Payer: UHC Exchange |
$801.77
|
| Rate for Payer: UHC Medicare Advantage |
$829.07
|
| Rate for Payer: UHCCP Medicaid |
$549.33
|
|
|
PR EXCISION LESION PANCREAS
|
Professional
|
Both
|
$2,275.00
|
|
|
Service Code
|
HCPCS 48120
|
| Min. Negotiated Rate |
$203.40 |
| Max. Negotiated Rate |
$199,787.00 |
| Rate for Payer: Aetna Commercial |
$1,451.70
|
| Rate for Payer: Aetna Medicare |
$1,126.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.04
|
| Rate for Payer: BCBS Complete |
$751.92
|
| Rate for Payer: BCBS MAPPO |
$1,083.36
|
| Rate for Payer: BCBS Trust/PPO |
$203.40
|
| Rate for Payer: BCN Commercial |
$1,628.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.36
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cash Price |
$1,820.00
|
| Rate for Payer: Cofinity Commercial |
$1,560.04
|
| Rate for Payer: Cofinity Commercial |
$1,451.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.36
|
| Rate for Payer: Healthscope Commercial |
$2,004.22
|
| Rate for Payer: Healthscope Commercial |
$1,733.38
|
| Rate for Payer: Mclaren Medicaid |
$716.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.53
|
| Rate for Payer: Meridian Medicaid |
$751.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199,787.00
|
| Rate for Payer: Nomi Health Commercial |
$1,300.03
|
| Rate for Payer: PACE SWMI |
$1,083.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,478.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,995.61
|
| Rate for Payer: Priority Health Medicare |
$1,083.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,995.61
|
| Rate for Payer: Priority Health SBD |
$1,995.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,050.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.36
|
| Rate for Payer: UHC Exchange |
$1,050.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.36
|
| Rate for Payer: UHCCP Medicaid |
$716.11
|
|
|
PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK
|
Professional
|
Both
|
$1,344.00
|
|
|
Service Code
|
HCPCS 27630
|
| Min. Negotiated Rate |
$234.94 |
| Max. Negotiated Rate |
$62,647.00 |
| Rate for Payer: Aetna Commercial |
$462.66
|
| Rate for Payer: Aetna Medicare |
$359.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$462.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$497.19
|
| Rate for Payer: BCBS Complete |
$246.69
|
| Rate for Payer: BCBS MAPPO |
$345.27
|
| Rate for Payer: BCBS Trust/PPO |
$600.15
|
| Rate for Payer: BCN Commercial |
$785.31
|
| Rate for Payer: BCN Medicare Advantage |
$345.27
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cash Price |
$1,075.20
|
| Rate for Payer: Cofinity Commercial |
$497.19
|
| Rate for Payer: Cofinity Commercial |
$462.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.27
|
| Rate for Payer: Healthscope Commercial |
$638.75
|
| Rate for Payer: Healthscope Commercial |
$552.43
|
| Rate for Payer: Mclaren Medicaid |
$234.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.53
|
| Rate for Payer: Meridian Medicaid |
$246.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,647.00
|
| Rate for Payer: Nomi Health Commercial |
$414.32
|
| Rate for Payer: PACE SWMI |
$345.27
|
| Rate for Payer: PHP Medicare Advantage |
$345.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$873.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$553.64
|
| Rate for Payer: Priority Health Medicare |
$345.27
|
| Rate for Payer: Priority Health Narrow Network |
$553.64
|
| Rate for Payer: Priority Health SBD |
$553.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.27
|
| Rate for Payer: UHC Exchange |
$699.44
|
| Rate for Payer: UHC Medicare Advantage |
$345.27
|
| Rate for Payer: UHCCP Medicaid |
$234.94
|
|
|
PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST
|
Professional
|
Both
|
$1,155.00
|
|
|
Service Code
|
HCPCS 25110
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$61,628.00 |
| Rate for Payer: Aetna Commercial |
$449.60
|
| Rate for Payer: Aetna Medicare |
$348.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$483.15
|
| Rate for Payer: BCBS Complete |
$240.87
|
| Rate for Payer: BCBS MAPPO |
$335.52
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$516.04
|
| Rate for Payer: BCN Medicare Advantage |
$335.52
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cash Price |
$924.00
|
| Rate for Payer: Cofinity Commercial |
$483.15
|
| Rate for Payer: Cofinity Commercial |
$449.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.52
|
| Rate for Payer: Healthscope Commercial |
$620.71
|
| Rate for Payer: Healthscope Commercial |
$536.83
|
| Rate for Payer: Mclaren Medicaid |
$229.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.30
|
| Rate for Payer: Meridian Medicaid |
$240.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,628.00
|
| Rate for Payer: Nomi Health Commercial |
$402.62
|
| Rate for Payer: PACE SWMI |
$335.52
|
| Rate for Payer: PHP Medicare Advantage |
$335.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$542.44
|
| Rate for Payer: Priority Health Medicare |
$335.52
|
| Rate for Payer: Priority Health Narrow Network |
$542.44
|
| Rate for Payer: Priority Health SBD |
$542.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.52
|
| Rate for Payer: UHC Exchange |
$497.08
|
| Rate for Payer: UHC Medicare Advantage |
$335.52
|
| Rate for Payer: UHCCP Medicaid |
$229.40
|
|
|
PR EXCISION LESION TONGUE W/O CLOSURE
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 41110
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$22,795.00 |
| Rate for Payer: Aetna Commercial |
$163.19
|
| Rate for Payer: Aetna Medicare |
$126.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.36
|
| Rate for Payer: BCBS Complete |
$87.68
|
| Rate for Payer: BCBS MAPPO |
$121.78
|
| Rate for Payer: BCBS Trust/PPO |
$569.51
|
| Rate for Payer: BCN Commercial |
$340.12
|
| Rate for Payer: BCN Medicare Advantage |
$121.78
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$175.36
|
| Rate for Payer: Cofinity Commercial |
$163.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.78
|
| Rate for Payer: Healthscope Commercial |
$225.29
|
| Rate for Payer: Healthscope Commercial |
$194.85
|
| Rate for Payer: Mclaren Medicaid |
$83.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.87
|
| Rate for Payer: Meridian Medicaid |
$87.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,795.00
|
| Rate for Payer: Nomi Health Commercial |
$146.14
|
| Rate for Payer: PACE SWMI |
$121.78
|
| Rate for Payer: PHP Medicare Advantage |
$121.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.46
|
| Rate for Payer: Priority Health Medicare |
$121.78
|
| Rate for Payer: Priority Health Narrow Network |
$234.46
|
| Rate for Payer: Priority Health SBD |
$234.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.78
|
| Rate for Payer: UHC Exchange |
$167.82
|
| Rate for Payer: UHC Medicare Advantage |
$121.78
|
| Rate for Payer: UHCCP Medicaid |
$83.50
|
|
|
PR EXCISION LINGUAL FRENUM FRENECTOMY
|
Professional
|
Both
|
$447.00
|
|
|
Service Code
|
HCPCS 41115
|
| Min. Negotiated Rate |
$94.15 |
| Max. Negotiated Rate |
$25,673.00 |
| Rate for Payer: Aetna Commercial |
$184.28
|
| Rate for Payer: Aetna Medicare |
$143.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.03
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS MAPPO |
$137.52
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$387.03
|
| Rate for Payer: BCN Medicare Advantage |
$137.52
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cash Price |
$357.60
|
| Rate for Payer: Cofinity Commercial |
$198.03
|
| Rate for Payer: Cofinity Commercial |
$184.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.52
|
| Rate for Payer: Healthscope Commercial |
$254.41
|
| Rate for Payer: Healthscope Commercial |
$220.03
|
| Rate for Payer: Mclaren Medicaid |
$94.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.40
|
| Rate for Payer: Meridian Medicaid |
$98.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,673.00
|
| Rate for Payer: Nomi Health Commercial |
$165.02
|
| Rate for Payer: PACE SWMI |
$137.52
|
| Rate for Payer: PHP Medicare Advantage |
$137.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.69
|
| Rate for Payer: Priority Health Medicare |
$137.52
|
| Rate for Payer: Priority Health Narrow Network |
$263.69
|
| Rate for Payer: Priority Health SBD |
$263.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.52
|
| Rate for Payer: UHC Exchange |
$210.95
|
| Rate for Payer: UHC Medicare Advantage |
$137.52
|
| Rate for Payer: UHCCP Medicaid |
$94.15
|
|
|
PR EXCISION LOCAL LESION EPIDIDYMIS
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
HCPCS 54830
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$65,390.00 |
| Rate for Payer: Aetna Commercial |
$477.67
|
| Rate for Payer: Aetna Medicare |
$370.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.32
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$356.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,910.86
|
| Rate for Payer: BCN Commercial |
$539.99
|
| Rate for Payer: BCN Medicare Advantage |
$356.47
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cofinity Commercial |
$513.32
|
| Rate for Payer: Cofinity Commercial |
$477.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.47
|
| Rate for Payer: Healthscope Commercial |
$659.47
|
| Rate for Payer: Healthscope Commercial |
$570.35
|
| Rate for Payer: Mclaren Medicaid |
$240.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$374.29
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65,390.00
|
| Rate for Payer: Nomi Health Commercial |
$427.76
|
| Rate for Payer: PACE SWMI |
$356.47
|
| Rate for Payer: PHP Medicare Advantage |
$356.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$598.11
|
| Rate for Payer: Priority Health Medicare |
$356.47
|
| Rate for Payer: Priority Health Narrow Network |
$598.11
|
| Rate for Payer: Priority Health SBD |
$598.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$414.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.47
|
| Rate for Payer: UHC Exchange |
$414.83
|
| Rate for Payer: UHC Medicare Advantage |
$356.47
|
| Rate for Payer: UHCCP Medicaid |
$240.69
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
IP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$209.79 |
| Max. Negotiated Rate |
$299.70 |
| Rate for Payer: Aetna Commercial |
$283.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.45
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$233.10
|
| Rate for Payer: Cofinity Commercial |
$286.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Healthscope Commercial |
$299.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.05
|
| Rate for Payer: PHP Commercial |
$283.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health SBD |
$209.79
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Facility
|
OP
|
$333.00
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
11640
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$283.05
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.45
|
| 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 |
$102.75
|
| Rate for Payer: BCN Commercial |
$102.75
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$286.38
|
| Rate for Payer: Cofinity Commercial |
$233.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$299.70
|
| 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 |
$283.05
|
| 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 |
$283.05
|
| 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 |
$216.45
|
| 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 |
$209.79
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.35
|
| 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 EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11640
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$22,001.00 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Medicare |
$124.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.01
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$119.45
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: BCN Medicare Advantage |
$119.45
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$172.01
|
| Rate for Payer: Cofinity Commercial |
$160.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.45
|
| Rate for Payer: Healthscope Commercial |
$220.98
|
| Rate for Payer: Healthscope Commercial |
$191.12
|
| Rate for Payer: Mclaren Medicaid |
$81.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.42
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,001.00
|
| Rate for Payer: Nomi Health Commercial |
$143.34
|
| Rate for Payer: PACE SWMI |
$119.45
|
| Rate for Payer: PHP Medicare Advantage |
$119.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Medicare |
$119.45
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: Priority Health SBD |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.45
|
| Rate for Payer: UHC Exchange |
$180.54
|
| Rate for Payer: UHC Medicare Advantage |
$119.45
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<
|
Professional
|
Both
|
$333.00
|
|
|
Service Code
|
HCPCS 11640
|
| Hospital Charge Code |
11640
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$22,001.00 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Medicare |
$124.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.01
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$119.45
|
| Rate for Payer: BCBS Trust/PPO |
$977.96
|
| Rate for Payer: BCN Commercial |
$239.53
|
| Rate for Payer: BCN Medicare Advantage |
$119.45
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cofinity Commercial |
$160.06
|
| Rate for Payer: Cofinity Commercial |
$172.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.45
|
| Rate for Payer: Healthscope Commercial |
$220.98
|
| Rate for Payer: Healthscope Commercial |
$191.12
|
| Rate for Payer: Mclaren Medicaid |
$81.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.42
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,001.00
|
| Rate for Payer: Nomi Health Commercial |
$143.34
|
| Rate for Payer: PACE SWMI |
$119.45
|
| Rate for Payer: PHP Medicare Advantage |
$119.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.03
|
| Rate for Payer: Priority Health Medicare |
$119.45
|
| Rate for Payer: Priority Health Narrow Network |
$172.03
|
| Rate for Payer: Priority Health SBD |
$172.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.45
|
| Rate for Payer: UHC Exchange |
$180.54
|
| Rate for Payer: UHC Medicare Advantage |
$119.45
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| 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 |
$116.10
|
| Rate for Payer: BCN Commercial |
$116.10
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$275.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| 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 |
$334.90
|
| 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 |
$334.90
|
| 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 |
$256.10
|
| 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 |
$248.22
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.42
|
| 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 EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$27,122.00 |
| Rate for Payer: Aetna Commercial |
$197.14
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$147.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$279.57
|
| Rate for Payer: BCN Medicare Advantage |
$147.12
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$211.85
|
| Rate for Payer: Cofinity Commercial |
$197.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.12
|
| Rate for Payer: Healthscope Commercial |
$272.17
|
| Rate for Payer: Healthscope Commercial |
$235.39
|
| Rate for Payer: Mclaren Medicaid |
$100.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.48
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,122.00
|
| Rate for Payer: Nomi Health Commercial |
$176.54
|
| Rate for Payer: PACE SWMI |
$147.12
|
| Rate for Payer: PHP Medicare Advantage |
$147.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.41
|
| Rate for Payer: Priority Health Medicare |
$147.12
|
| Rate for Payer: Priority Health Narrow Network |
$210.41
|
| Rate for Payer: Priority Health SBD |
$210.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.12
|
| Rate for Payer: UHC Exchange |
$239.57
|
| Rate for Payer: UHC Medicare Advantage |
$147.12
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 11641
|
| Hospital Charge Code |
11641
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$27,122.00 |
| Rate for Payer: Aetna Commercial |
$197.14
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.85
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$147.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.96
|
| Rate for Payer: BCN Commercial |
$279.57
|
| Rate for Payer: BCN Medicare Advantage |
$147.12
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$211.85
|
| Rate for Payer: Cofinity Commercial |
$197.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.12
|
| Rate for Payer: Healthscope Commercial |
$272.17
|
| Rate for Payer: Healthscope Commercial |
$235.39
|
| Rate for Payer: Mclaren Medicaid |
$100.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.48
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,122.00
|
| Rate for Payer: Nomi Health Commercial |
$176.54
|
| Rate for Payer: PACE SWMI |
$147.12
|
| Rate for Payer: PHP Medicare Advantage |
$147.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.41
|
| Rate for Payer: Priority Health Medicare |
$147.12
|
| Rate for Payer: Priority Health Narrow Network |
$210.41
|
| Rate for Payer: Priority Health SBD |
$210.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.12
|
| Rate for Payer: UHC Exchange |
$239.57
|
| Rate for Payer: UHC Medicare Advantage |
$147.12
|
| Rate for Payer: UHCCP Medicaid |
$100.11
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
11641
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$248.22 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$275.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health SBD |
$248.22
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$190.44 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$506.60
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.40
|
| 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 |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Cofinity Commercial |
$417.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$536.40
|
| 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 |
$506.60
|
| 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 |
$506.60
|
| 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 |
$387.40
|
| 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 |
$375.48
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| 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 EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$31,685.00 |
| Rate for Payer: Aetna Commercial |
$230.24
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.42
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$171.82
|
| Rate for Payer: BCBS Trust/PPO |
$712.50
|
| Rate for Payer: BCN Commercial |
$315.30
|
| Rate for Payer: BCN Medicare Advantage |
$171.82
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$247.42
|
| Rate for Payer: Cofinity Commercial |
$230.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.82
|
| Rate for Payer: Healthscope Commercial |
$317.87
|
| Rate for Payer: Healthscope Commercial |
$274.91
|
| Rate for Payer: Mclaren Medicaid |
$116.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.41
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,685.00
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: PACE SWMI |
$171.82
|
| Rate for Payer: PHP Medicare Advantage |
$171.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.08
|
| Rate for Payer: Priority Health Medicare |
$171.82
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: Priority Health SBD |
$246.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.82
|
| Rate for Payer: UHC Exchange |
$282.80
|
| Rate for Payer: UHC Medicare Advantage |
$171.82
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
11642
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$375.48 |
| Max. Negotiated Rate |
$536.40 |
| Rate for Payer: Aetna Commercial |
$506.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.40
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$417.20
|
| Rate for Payer: Cofinity Commercial |
$512.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.80
|
| Rate for Payer: Healthscope Commercial |
$536.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.60
|
| Rate for Payer: PHP Commercial |
$506.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health SBD |
$375.48
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
11642
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$31,685.00 |
| Rate for Payer: Aetna Commercial |
$230.24
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.42
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$171.82
|
| Rate for Payer: BCBS Trust/PPO |
$712.50
|
| Rate for Payer: BCN Commercial |
$315.30
|
| Rate for Payer: BCN Medicare Advantage |
$171.82
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$247.42
|
| Rate for Payer: Cofinity Commercial |
$230.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.82
|
| Rate for Payer: Healthscope Commercial |
$317.87
|
| Rate for Payer: Healthscope Commercial |
$274.91
|
| Rate for Payer: Mclaren Medicaid |
$116.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.41
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,685.00
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: PACE SWMI |
$171.82
|
| Rate for Payer: PHP Medicare Advantage |
$171.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.08
|
| Rate for Payer: Priority Health Medicare |
$171.82
|
| Rate for Payer: Priority Health Narrow Network |
$246.08
|
| Rate for Payer: Priority Health SBD |
$246.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.82
|
| Rate for Payer: UHC Exchange |
$282.80
|
| Rate for Payer: UHC Medicare Advantage |
$171.82
|
| Rate for Payer: UHCCP Medicaid |
$116.72
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
11643
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$469.35 |
| Max. Negotiated Rate |
$670.50 |
| Rate for Payer: Aetna Commercial |
$633.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.25
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$521.50
|
| Rate for Payer: Cofinity Commercial |
$640.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$521.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.00
|
| Rate for Payer: Healthscope Commercial |
$670.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.25
|
| Rate for Payer: PHP Commercial |
$633.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health SBD |
$469.35
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Hospital Charge Code |
11643
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$39,753.00 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$224.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.13
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$370.68
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Healthscope Commercial |
$399.71
|
| Rate for Payer: Healthscope Commercial |
$345.70
|
| Rate for Payer: Mclaren Medicaid |
$146.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,753.00
|
| Rate for Payer: Nomi Health Commercial |
$259.27
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$216.06
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: Priority Health SBD |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.06
|
| Rate for Payer: UHC Exchange |
$332.92
|
| Rate for Payer: UHC Medicare Advantage |
$216.06
|
| Rate for Payer: UHCCP Medicaid |
$146.12
|
|
|
PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM
|
Professional
|
Both
|
$745.00
|
|
|
Service Code
|
HCPCS 11643
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$39,753.00 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$224.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.13
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$370.68
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cash Price |
$596.00
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Healthscope Commercial |
$399.71
|
| Rate for Payer: Healthscope Commercial |
$345.70
|
| Rate for Payer: Mclaren Medicaid |
$146.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,753.00
|
| Rate for Payer: Nomi Health Commercial |
$259.27
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$306.58
|
| Rate for Payer: Priority Health Medicare |
$216.06
|
| Rate for Payer: Priority Health Narrow Network |
$306.58
|
| Rate for Payer: Priority Health SBD |
$306.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.06
|
| Rate for Payer: UHC Exchange |
$332.92
|
| Rate for Payer: UHC Medicare Advantage |
$216.06
|
| Rate for Payer: UHCCP Medicaid |
$146.12
|
|
