|
PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 11626
|
| Min. Negotiated Rate |
$186.38 |
| Max. Negotiated Rate |
$51,379.00 |
| 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 |
$195.70
|
| Rate for Payer: BCBS MAPPO |
$277.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$478.66
|
| 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 |
$513.63
|
| Rate for Payer: Healthscope Commercial |
$444.22
|
| Rate for Payer: Mclaren Medicaid |
$186.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.52
|
| Rate for Payer: Meridian Medicaid |
$195.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,379.00
|
| 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 Choice Medicaid |
$186.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.37
|
| Rate for Payer: Priority Health Medicare |
$277.64
|
| Rate for Payer: Priority Health Narrow Network |
$392.37
|
| Rate for Payer: Priority Health SBD |
$392.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.64
|
| Rate for Payer: UHC Exchange |
$419.09
|
| Rate for Payer: UHC Medicare Advantage |
$277.64
|
| Rate for Payer: UHCCP Medicaid |
$186.38
|
|
|
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 |
$307.19 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Commercial |
$790.50
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$922.00
|
| Rate for Payer: BCN Commercial |
$922.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$744.00
|
| 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 |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$837.00
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.50
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$790.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$585.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.19
|
| Rate for Payer: UHC Core |
$4,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,578.75
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 11606
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$55,739.00 |
| 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 |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCBS Trust/PPO |
$592.45
|
| Rate for Payer: BCN Commercial |
$654.83
|
| 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: Mclaren Medicaid |
$202.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,739.00
|
| 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 Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.14
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: Priority Health Narrow Network |
$427.14
|
| Rate for Payer: Priority Health SBD |
$427.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Exchange |
$348.28
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
|
|
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 |
$202.35 |
| Max. Negotiated Rate |
$55,739.00 |
| 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 |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$301.60
|
| Rate for Payer: BCBS Trust/PPO |
$592.45
|
| Rate for Payer: BCN Commercial |
$654.83
|
| 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: Mclaren Medicaid |
$202.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.68
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55,739.00
|
| 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 Choice Medicaid |
$202.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.14
|
| Rate for Payer: Priority Health Medicare |
$301.60
|
| Rate for Payer: Priority Health Narrow Network |
$427.14
|
| Rate for Payer: Priority Health SBD |
$427.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.60
|
| Rate for Payer: UHC Exchange |
$348.28
|
| Rate for Payer: UHC Medicare Advantage |
$301.60
|
| Rate for Payer: UHCCP Medicaid |
$202.35
|
|
|
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 |
$334.71 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Commercial |
$682.55
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,354.44
|
| Rate for Payer: BCN Commercial |
$1,354.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$642.40
|
| 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 |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$722.70
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$682.55
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$682.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$505.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.71
|
| Rate for Payer: UHC Core |
$3,138.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$893.75
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR 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 TUMOR MANDIBLE RADICAL
|
Professional
|
Both
|
$2,220.00
|
|
|
Service Code
|
HCPCS 21045
|
| Min. Negotiated Rate |
$99.81 |
| Max. Negotiated Rate |
$211,923.00 |
| Rate for Payer: Aetna Commercial |
$1,527.49
|
| Rate for Payer: Aetna Medicare |
$1,185.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,527.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,641.48
|
| Rate for Payer: BCBS Complete |
$808.50
|
| Rate for Payer: BCBS MAPPO |
$1,139.92
|
| Rate for Payer: BCBS Trust/PPO |
$99.81
|
| Rate for Payer: BCN Commercial |
$1,753.86
|
| 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 |
$2,108.85
|
| Rate for Payer: Healthscope Commercial |
$1,823.87
|
| Rate for Payer: Mclaren Medicaid |
$770.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.92
|
| Rate for Payer: Meridian Medicaid |
$808.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211,923.00
|
| 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 Choice Medicaid |
$770.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,443.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,831.90
|
| Rate for Payer: Priority Health Medicare |
$1,139.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,831.90
|
| Rate for Payer: Priority Health SBD |
$1,831.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,220.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,139.92
|
| Rate for Payer: UHC Exchange |
$1,220.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.92
|
| Rate for Payer: UHCCP Medicaid |
$770.00
|
|
|
PR EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 21034
|
| Min. Negotiated Rate |
$722.28 |
| Max. Negotiated Rate |
$199,004.00 |
| Rate for Payer: Aetna Commercial |
$1,433.64
|
| Rate for Payer: Aetna Medicare |
$1,112.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,433.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.63
|
| Rate for Payer: BCBS Complete |
$758.39
|
| Rate for Payer: BCBS MAPPO |
$1,069.88
|
| Rate for Payer: BCN Commercial |
$1,900.96
|
| 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: Mclaren Medicaid |
$722.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.37
|
| Rate for Payer: Meridian Medicaid |
$758.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199,004.00
|
| 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 Choice Medicaid |
$722.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,719.43
|
| Rate for Payer: Priority Health Medicare |
$1,069.88
|
| Rate for Payer: Priority Health Narrow Network |
$1,719.43
|
| Rate for Payer: Priority Health SBD |
$1,719.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.88
|
| Rate for Payer: UHC Exchange |
$1,241.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.88
|
| Rate for Payer: UHCCP Medicaid |
$722.28
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 11600
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$21,334.00 |
| Rate for Payer: Aetna Commercial |
$154.38
|
| Rate for Payer: Aetna Medicare |
$119.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.90
|
| Rate for Payer: BCBS Complete |
$82.53
|
| Rate for Payer: BCBS MAPPO |
$115.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,866.00
|
| Rate for Payer: BCN Commercial |
$290.27
|
| 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 |
$213.14
|
| Rate for Payer: Healthscope Commercial |
$184.34
|
| Rate for Payer: Mclaren Medicaid |
$78.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.97
|
| Rate for Payer: Meridian Medicaid |
$82.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,334.00
|
| 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 Choice Medicaid |
$78.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.16
|
| Rate for Payer: Priority Health Medicare |
$115.21
|
| Rate for Payer: Priority Health Narrow Network |
$166.16
|
| Rate for Payer: Priority Health SBD |
$166.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.21
|
| Rate for Payer: UHC Exchange |
$184.43
|
| Rate for Payer: UHC Medicare Advantage |
$115.21
|
| Rate for Payer: UHCCP Medicaid |
$78.60
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 11601
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$25,880.00 |
| Rate for Payer: Aetna Commercial |
$187.72
|
| Rate for Payer: Aetna Medicare |
$145.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.73
|
| Rate for Payer: BCBS Complete |
$100.19
|
| Rate for Payer: BCBS MAPPO |
$140.09
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$269.37
|
| 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: Mclaren Medicaid |
$95.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.09
|
| Rate for Payer: Meridian Medicaid |
$100.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,880.00
|
| 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 Choice Medicaid |
$95.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.93
|
| Rate for Payer: Priority Health Medicare |
$140.09
|
| Rate for Payer: Priority Health Narrow Network |
$200.93
|
| Rate for Payer: Priority Health SBD |
$200.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.09
|
| Rate for Payer: UHC Exchange |
$196.70
|
| Rate for Payer: UHC Medicare Advantage |
$140.09
|
| Rate for Payer: UHCCP Medicaid |
$95.42
|
|
|
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 |
$46.61 |
| Max. Negotiated Rate |
$28,102.00 |
| 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 |
$108.92
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$288.21
|
| 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 |
$281.50
|
| Rate for Payer: Healthscope Commercial |
$243.46
|
| Rate for Payer: Mclaren Medicaid |
$103.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Meridian Medicaid |
$108.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,102.00
|
| 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 Choice Medicaid |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.08
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: Priority Health Narrow Network |
$218.08
|
| Rate for Payer: Priority Health SBD |
$218.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Exchange |
$190.55
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
| Rate for Payer: UHCCP Medicaid |
$103.73
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 11602
|
| Min. Negotiated Rate |
$46.61 |
| Max. Negotiated Rate |
$28,102.00 |
| 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 |
$108.92
|
| Rate for Payer: BCBS MAPPO |
$152.16
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$288.21
|
| 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 |
$281.50
|
| Rate for Payer: Healthscope Commercial |
$243.46
|
| Rate for Payer: Mclaren Medicaid |
$103.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.77
|
| Rate for Payer: Meridian Medicaid |
$108.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,102.00
|
| 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 Choice Medicaid |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.08
|
| Rate for Payer: Priority Health Medicare |
$152.16
|
| Rate for Payer: Priority Health Narrow Network |
$218.08
|
| Rate for Payer: Priority Health SBD |
$218.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.16
|
| Rate for Payer: UHC Exchange |
$190.55
|
| Rate for Payer: UHC Medicare Advantage |
$152.16
|
| Rate for Payer: UHCCP Medicaid |
$103.73
|
|
|
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 |
$168.12 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Commercial |
$348.50
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$325.31
|
| Rate for Payer: BCN Commercial |
$325.31
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$328.00
|
| 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 |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$369.00
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.50
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$348.50
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$258.30
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.12
|
| Rate for Payer: UHC Core |
$878.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$220.39
|
| Rate for Payer: VA VA |
$391.45
|
|
|
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 |
$201.58 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$396.95
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.55
|
| 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 |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cash Price |
$373.60
|
| Rate for Payer: Cofinity Commercial |
$401.62
|
| Rate for Payer: Cofinity Commercial |
$326.90
|
| 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 |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$420.30
|
| 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 |
$396.95
|
| 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 |
$396.95
|
| 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 |
$303.55
|
| 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 |
$294.21
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.58
|
| 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 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 |
$28.95 |
| Max. Negotiated Rate |
$33,779.00 |
| 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 |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$409.03
|
| 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: Mclaren Medicaid |
$123.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,779.00
|
| 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 Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.53
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: Priority Health Narrow Network |
$260.53
|
| Rate for Payer: Priority Health SBD |
$260.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Exchange |
$220.46
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM
|
Professional
|
Both
|
$467.00
|
|
|
Service Code
|
HCPCS 11603
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$33,779.00 |
| 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 |
$130.17
|
| Rate for Payer: BCBS MAPPO |
$182.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$409.03
|
| 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: Mclaren Medicaid |
$123.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.62
|
| Rate for Payer: Meridian Medicaid |
$130.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33,779.00
|
| 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 Choice Medicaid |
$123.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.53
|
| Rate for Payer: Priority Health Medicare |
$182.50
|
| Rate for Payer: Priority Health Narrow Network |
$260.53
|
| Rate for Payer: Priority Health SBD |
$260.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.50
|
| Rate for Payer: UHC Exchange |
$220.46
|
| Rate for Payer: UHC Medicare Advantage |
$182.50
|
| Rate for Payer: UHCCP Medicaid |
$123.97
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 11604
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$37,264.00 |
| 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 |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$201.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,686.65
|
| Rate for Payer: BCN Commercial |
$455.45
|
| 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 |
$373.07
|
| Rate for Payer: Healthscope Commercial |
$322.66
|
| Rate for Payer: Mclaren Medicaid |
$136.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.74
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,264.00
|
| 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 Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.72
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: Priority Health Narrow Network |
$286.72
|
| Rate for Payer: Priority Health SBD |
$286.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.66
|
| Rate for Payer: UHC Exchange |
$253.50
|
| Rate for Payer: UHC Medicare Advantage |
$201.66
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
|
|
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 |
$136.53 |
| Max. Negotiated Rate |
$37,264.00 |
| 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 |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$201.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,686.65
|
| Rate for Payer: BCN Commercial |
$455.45
|
| 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 |
$373.07
|
| Rate for Payer: Healthscope Commercial |
$322.66
|
| Rate for Payer: Mclaren Medicaid |
$136.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.74
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,264.00
|
| 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 Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.72
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: Priority Health Narrow Network |
$286.72
|
| Rate for Payer: Priority Health SBD |
$286.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.66
|
| Rate for Payer: UHC Exchange |
$253.50
|
| Rate for Payer: UHC Medicare Advantage |
$201.66
|
| Rate for Payer: UHCCP Medicaid |
$136.53
|
|
|
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
|
|
|
PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM
|
Facility
|
OP
|
$521.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
11604
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$222.49 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Commercial |
$442.85
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$661.50
|
| Rate for Payer: BCN Commercial |
$661.50
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$448.06
|
| Rate for Payer: Cofinity Commercial |
$364.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$468.90
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.85
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$442.85
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$328.23
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.49
|
| Rate for Payer: UHC Core |
$1,463.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$388.11
|
| Rate for Payer: VA VA |
$689.36
|
|
|
PR EXCISION MAXILLARY TORUS PALATINUS
|
Professional
|
Both
|
$793.00
|
|
|
Service Code
|
HCPCS 21032
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$45,277.00 |
| Rate for Payer: Aetna Commercial |
$332.08
|
| Rate for Payer: Aetna Medicare |
$257.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$356.86
|
| Rate for Payer: BCBS Complete |
$178.47
|
| Rate for Payer: BCBS MAPPO |
$247.82
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$542.92
|
| Rate for Payer: BCN Medicare Advantage |
$247.82
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cash Price |
$634.40
|
| Rate for Payer: Cofinity Commercial |
$356.86
|
| Rate for Payer: Cofinity Commercial |
$332.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.82
|
| Rate for Payer: Healthscope Commercial |
$458.47
|
| Rate for Payer: Healthscope Commercial |
$396.51
|
| Rate for Payer: Mclaren Medicaid |
$169.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.21
|
| Rate for Payer: Meridian Medicaid |
$178.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,277.00
|
| Rate for Payer: Nomi Health Commercial |
$297.38
|
| Rate for Payer: PACE SWMI |
$247.82
|
| Rate for Payer: PHP Medicare Advantage |
$247.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$515.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$399.46
|
| Rate for Payer: Priority Health Medicare |
$247.82
|
| Rate for Payer: Priority Health Narrow Network |
$399.46
|
| Rate for Payer: Priority Health SBD |
$399.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.82
|
| Rate for Payer: UHC Exchange |
$324.54
|
| Rate for Payer: UHC Medicare Advantage |
$247.82
|
| Rate for Payer: UHCCP Medicaid |
$169.97
|
|
|
PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 46230
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$30,650.00 |
| Rate for Payer: Aetna Commercial |
$224.56
|
| Rate for Payer: Aetna Medicare |
$174.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.32
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$167.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,777.73
|
| Rate for Payer: BCN Commercial |
$459.85
|
| Rate for Payer: BCN Medicare Advantage |
$167.58
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$241.32
|
| Rate for Payer: Cofinity Commercial |
$224.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.58
|
| Rate for Payer: Healthscope Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$268.13
|
| Rate for Payer: Mclaren Medicaid |
$112.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.96
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,650.00
|
| Rate for Payer: Nomi Health Commercial |
$201.10
|
| Rate for Payer: PACE SWMI |
$167.58
|
| Rate for Payer: PHP Medicare Advantage |
$167.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.62
|
| Rate for Payer: Priority Health Medicare |
$167.58
|
| Rate for Payer: Priority Health Narrow Network |
$312.62
|
| Rate for Payer: Priority Health SBD |
$312.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.58
|
| Rate for Payer: UHC Exchange |
$284.44
|
| Rate for Payer: UHC Medicare Advantage |
$167.58
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR EXCISION NAIL MATRIX PERMANENT REMOVAL
|
Professional
|
Both
|
$483.00
|
|
|
Service Code
|
HCPCS 11750
|
| Min. Negotiated Rate |
$20.33 |
| Max. Negotiated Rate |
$17,593.00 |
| Rate for Payer: Aetna Commercial |
$128.80
|
| Rate for Payer: Aetna Medicare |
$99.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.41
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$96.12
|
| Rate for Payer: BCBS Trust/PPO |
$20.33
|
| Rate for Payer: BCN Commercial |
$187.30
|
| Rate for Payer: BCN Medicare Advantage |
$96.12
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Commercial |
$138.41
|
| Rate for Payer: Cofinity Commercial |
$128.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.12
|
| Rate for Payer: Healthscope Commercial |
$177.82
|
| Rate for Payer: Healthscope Commercial |
$153.79
|
| Rate for Payer: Mclaren Medicaid |
$65.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.93
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,593.00
|
| Rate for Payer: Nomi Health Commercial |
$115.34
|
| Rate for Payer: PACE SWMI |
$96.12
|
| Rate for Payer: PHP Medicare Advantage |
$96.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.16
|
| Rate for Payer: Priority Health Medicare |
$96.12
|
| Rate for Payer: Priority Health Narrow Network |
$138.16
|
| Rate for Payer: Priority Health SBD |
$138.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.12
|
| Rate for Payer: UHC Exchange |
$198.37
|
| Rate for Payer: UHC Medicare Advantage |
$96.12
|
| Rate for Payer: UHCCP Medicaid |
$65.39
|
|
