|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
OP
|
$384.54
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.33 |
| Max. Negotiated Rate |
$346.09 |
| Rate for Payer: Aetna Commercial |
$326.86
|
| Rate for Payer: Aetna Medicare |
$99.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.17
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$96.14
|
| Rate for Payer: BCBS Trust/PPO |
$298.98
|
| Rate for Payer: BCN Commercial |
$298.98
|
| Rate for Payer: BCN Medicare Advantage |
$96.14
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$330.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.14
|
| Rate for Payer: Healthscope Commercial |
$346.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
| Rate for Payer: PACE Senior Care Partners |
$91.33
|
| Rate for Payer: PACE SWMI |
$96.14
|
| Rate for Payer: PHP Commercial |
$326.86
|
| Rate for Payer: PHP Medicare Advantage |
$96.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.55
|
| Rate for Payer: Priority Health Medicare |
$96.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.53
|
| Rate for Payer: Railroad Medicare Medicare |
$96.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.40
|
| Rate for Payer: UHC Core |
$321.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.14
|
| Rate for Payer: UHC Medicare Advantage |
$99.02
|
| Rate for Payer: VA VA |
$96.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
OP
|
$384.54
|
|
|
Service Code
|
CPT 17283
|
| Hospital Charge Code |
76100156
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.33 |
| Max. Negotiated Rate |
$346.09 |
| Rate for Payer: Aetna Commercial |
$326.86
|
| Rate for Payer: Aetna Medicare |
$99.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.17
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$96.14
|
| Rate for Payer: BCBS Trust/PPO |
$298.98
|
| Rate for Payer: BCN Commercial |
$298.98
|
| Rate for Payer: BCN Medicare Advantage |
$96.14
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$330.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.14
|
| Rate for Payer: Healthscope Commercial |
$346.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
| Rate for Payer: PACE Senior Care Partners |
$91.33
|
| Rate for Payer: PACE SWMI |
$96.14
|
| Rate for Payer: PHP Commercial |
$326.86
|
| Rate for Payer: PHP Medicare Advantage |
$96.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.55
|
| Rate for Payer: Priority Health Medicare |
$96.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.53
|
| Rate for Payer: Railroad Medicare Medicare |
$96.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.40
|
| Rate for Payer: UHC Core |
$321.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.14
|
| Rate for Payer: UHC Medicare Advantage |
$99.02
|
| Rate for Payer: VA VA |
$96.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
IP
|
$384.54
|
|
|
Service Code
|
CPT 17283
|
| Hospital Charge Code |
76100156
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.53 |
| Max. Negotiated Rate |
$346.09 |
| Rate for Payer: Aetna Commercial |
$326.86
|
| Rate for Payer: BCBS Trust/PPO |
$297.17
|
| Rate for Payer: BCN Commercial |
$297.17
|
| Rate for Payer: Cash Price |
$307.63
|
| Rate for Payer: Cofinity Commercial |
$330.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
| Rate for Payer: Healthscope Commercial |
$346.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
| Rate for Payer: PHP Commercial |
$326.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.40
|
| Rate for Payer: UHC Core |
$321.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
IP
|
$590.58
|
|
|
Service Code
|
CPT 17284
|
| Hospital Charge Code |
76100157
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$360.19 |
| Max. Negotiated Rate |
$531.52 |
| Rate for Payer: Aetna Commercial |
$501.99
|
| Rate for Payer: BCBS Trust/PPO |
$456.40
|
| Rate for Payer: BCN Commercial |
$456.40
|
| Rate for Payer: Cash Price |
$472.46
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
| Rate for Payer: Healthscope Commercial |
$531.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.99
|
| Rate for Payer: PHP Commercial |
$501.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.71
|
| Rate for Payer: UHC Core |
$493.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
OP
|
$590.58
|
|
|
Service Code
|
CPT 17284
|
| Hospital Charge Code |
76100157
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.26 |
| Max. Negotiated Rate |
$531.52 |
| Rate for Payer: Aetna Commercial |
$501.99
|
| Rate for Payer: Aetna Medicare |
$153.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.56
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$147.64
|
| Rate for Payer: BCBS Trust/PPO |
$459.18
|
| Rate for Payer: BCN Commercial |
$459.18
|
| Rate for Payer: BCN Medicare Advantage |
$147.64
|
| Rate for Payer: Cash Price |
$472.46
|
| Rate for Payer: Cash Price |
$472.46
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.64
|
| Rate for Payer: Healthscope Commercial |
$531.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$155.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.99
|
| Rate for Payer: PACE Senior Care Partners |
$140.26
|
| Rate for Payer: PACE SWMI |
$147.64
|
| Rate for Payer: PHP Commercial |
$501.99
|
| Rate for Payer: PHP Medicare Advantage |
$147.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.80
|
| Rate for Payer: Priority Health Medicare |
$147.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.19
|
| Rate for Payer: Railroad Medicare Medicare |
$147.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.71
|
| Rate for Payer: UHC Core |
$493.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.64
|
| Rate for Payer: UHC Medicare Advantage |
$152.07
|
| Rate for Payer: VA VA |
$147.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
IP
|
$590.58
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$360.19 |
| Max. Negotiated Rate |
$531.52 |
| Rate for Payer: Aetna Commercial |
$501.99
|
| Rate for Payer: BCBS Trust/PPO |
$456.40
|
| Rate for Payer: BCN Commercial |
$456.40
|
| Rate for Payer: Cash Price |
$472.46
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
| Rate for Payer: Healthscope Commercial |
$531.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.99
|
| Rate for Payer: PHP Commercial |
$501.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.71
|
| Rate for Payer: UHC Core |
$493.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
OP
|
$590.58
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.26 |
| Max. Negotiated Rate |
$531.52 |
| Rate for Payer: Aetna Commercial |
$501.99
|
| Rate for Payer: Aetna Medicare |
$153.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.56
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$147.64
|
| Rate for Payer: BCBS Trust/PPO |
$459.18
|
| Rate for Payer: BCN Commercial |
$459.18
|
| Rate for Payer: BCN Medicare Advantage |
$147.64
|
| Rate for Payer: Cash Price |
$472.46
|
| Rate for Payer: Cash Price |
$472.46
|
| Rate for Payer: Cofinity Commercial |
$507.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.64
|
| Rate for Payer: Healthscope Commercial |
$531.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$155.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.99
|
| Rate for Payer: PACE Senior Care Partners |
$140.26
|
| Rate for Payer: PACE SWMI |
$147.64
|
| Rate for Payer: PHP Commercial |
$501.99
|
| Rate for Payer: PHP Medicare Advantage |
$147.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.80
|
| Rate for Payer: Priority Health Medicare |
$147.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.19
|
| Rate for Payer: Railroad Medicare Medicare |
$147.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.71
|
| Rate for Payer: UHC Core |
$493.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.64
|
| Rate for Payer: UHC Medicare Advantage |
$152.07
|
| Rate for Payer: VA VA |
$147.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.18 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: Aetna Medicare |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.19
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$134.82
|
| Rate for Payer: BCN Commercial |
$134.82
|
| Rate for Payer: BCN Medicare Advantage |
$43.35
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.35
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
| Rate for Payer: PACE Senior Care Partners |
$41.18
|
| Rate for Payer: PACE SWMI |
$43.35
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: PHP Medicare Advantage |
$43.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.86
|
| Rate for Payer: Priority Health Medicare |
$43.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.76
|
| Rate for Payer: Railroad Medicare Medicare |
$43.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.59
|
| Rate for Payer: UHC Core |
$144.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.35
|
| Rate for Payer: UHC Medicare Advantage |
$44.65
|
| Rate for Payer: VA VA |
$43.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
IP
|
$173.40
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.76 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: BCBS Trust/PPO |
$134.00
|
| Rate for Payer: BCN Commercial |
$134.00
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.59
|
| Rate for Payer: UHC Core |
$144.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
OP
|
$480.42
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$432.38 |
| Rate for Payer: Aetna Commercial |
$408.36
|
| Rate for Payer: Aetna Medicare |
$124.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.13
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$120.10
|
| Rate for Payer: BCBS Trust/PPO |
$373.53
|
| Rate for Payer: BCN Commercial |
$373.53
|
| Rate for Payer: BCN Medicare Advantage |
$120.10
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$413.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.10
|
| Rate for Payer: Healthscope Commercial |
$432.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PACE Senior Care Partners |
$114.10
|
| Rate for Payer: PACE SWMI |
$120.10
|
| Rate for Payer: PHP Commercial |
$408.36
|
| Rate for Payer: PHP Medicare Advantage |
$120.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.97
|
| Rate for Payer: Priority Health Medicare |
$120.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.01
|
| Rate for Payer: Railroad Medicare Medicare |
$120.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.77
|
| Rate for Payer: UHC Core |
$401.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.10
|
| Rate for Payer: UHC Medicare Advantage |
$123.71
|
| Rate for Payer: VA VA |
$120.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
IP
|
$480.42
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$293.01 |
| Max. Negotiated Rate |
$432.38 |
| Rate for Payer: Aetna Commercial |
$408.36
|
| Rate for Payer: BCBS Trust/PPO |
$371.27
|
| Rate for Payer: BCN Commercial |
$371.27
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$413.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Healthscope Commercial |
$432.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PHP Commercial |
$408.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.77
|
| Rate for Payer: UHC Core |
$401.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: Aetna Medicare |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.58
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$39.66
|
| Rate for Payer: BCBS Trust/PPO |
$123.35
|
| Rate for Payer: BCN Commercial |
$123.35
|
| Rate for Payer: BCN Medicare Advantage |
$39.66
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.66
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PACE Senior Care Partners |
$37.68
|
| Rate for Payer: PACE SWMI |
$39.66
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: PHP Medicare Advantage |
$39.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: Railroad Medicare Medicare |
$39.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: VA VA |
$39.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.76 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Aetna Commercial |
$134.85
|
| Rate for Payer: BCBS Trust/PPO |
$122.60
|
| Rate for Payer: BCN Commercial |
$122.60
|
| Rate for Payer: Cash Price |
$126.92
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.92
|
| Rate for Payer: Healthscope Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.85
|
| Rate for Payer: PHP Commercial |
$134.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.61
|
| Rate for Payer: UHC Core |
$132.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.99
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
IP
|
$173.07
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.56 |
| Max. Negotiated Rate |
$155.76 |
| Rate for Payer: Aetna Commercial |
$147.11
|
| Rate for Payer: BCBS Trust/PPO |
$133.75
|
| Rate for Payer: BCN Commercial |
$133.75
|
| Rate for Payer: Cash Price |
$138.46
|
| Rate for Payer: Cofinity Commercial |
$148.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.46
|
| Rate for Payer: Healthscope Commercial |
$155.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.11
|
| Rate for Payer: PHP Commercial |
$147.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.30
|
| Rate for Payer: UHC Core |
$144.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.80
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
OP
|
$173.07
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.10 |
| Max. Negotiated Rate |
$155.76 |
| Rate for Payer: Aetna Commercial |
$147.11
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.08
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$43.27
|
| Rate for Payer: BCBS Trust/PPO |
$134.56
|
| Rate for Payer: BCN Commercial |
$134.56
|
| Rate for Payer: BCN Medicare Advantage |
$43.27
|
| Rate for Payer: Cash Price |
$138.46
|
| Rate for Payer: Cash Price |
$138.46
|
| Rate for Payer: Cofinity Commercial |
$148.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.27
|
| Rate for Payer: Healthscope Commercial |
$155.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.80
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.11
|
| Rate for Payer: PACE Senior Care Partners |
$41.10
|
| Rate for Payer: PACE SWMI |
$43.27
|
| Rate for Payer: PHP Commercial |
$147.11
|
| Rate for Payer: PHP Medicare Advantage |
$43.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.57
|
| Rate for Payer: Priority Health Medicare |
$43.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.56
|
| Rate for Payer: Railroad Medicare Medicare |
$43.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.30
|
| Rate for Payer: UHC Core |
$144.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.27
|
| Rate for Payer: UHC Medicare Advantage |
$44.57
|
| Rate for Payer: VA VA |
$43.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.80
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
OP
|
$1,407.60
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$334.30 |
| Max. Negotiated Rate |
$1,266.84 |
| Rate for Payer: Aetna Commercial |
$1,196.46
|
| Rate for Payer: Aetna Medicare |
$365.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$439.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$439.88
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$351.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.41
|
| Rate for Payer: BCN Commercial |
$1,094.41
|
| Rate for Payer: BCN Medicare Advantage |
$351.90
|
| Rate for Payer: Cash Price |
$1,126.08
|
| Rate for Payer: Cash Price |
$1,126.08
|
| Rate for Payer: Cofinity Commercial |
$1,210.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.90
|
| Rate for Payer: Healthscope Commercial |
$1,266.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,055.70
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,196.46
|
| Rate for Payer: PACE Senior Care Partners |
$334.30
|
| Rate for Payer: PACE SWMI |
$351.90
|
| Rate for Payer: PHP Commercial |
$1,196.46
|
| Rate for Payer: PHP Medicare Advantage |
$351.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.61
|
| Rate for Payer: Priority Health Medicare |
$351.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.50
|
| Rate for Payer: Railroad Medicare Medicare |
$351.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.69
|
| Rate for Payer: UHC Core |
$1,175.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.90
|
| Rate for Payer: UHC Medicare Advantage |
$362.46
|
| Rate for Payer: VA VA |
$351.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,055.70
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
IP
|
$1,407.60
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$858.50 |
| Max. Negotiated Rate |
$1,266.84 |
| Rate for Payer: Aetna Commercial |
$1,196.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.79
|
| Rate for Payer: BCN Commercial |
$1,087.79
|
| Rate for Payer: Cash Price |
$1,126.08
|
| Rate for Payer: Cofinity Commercial |
$1,210.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.08
|
| Rate for Payer: Healthscope Commercial |
$1,266.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,055.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,196.46
|
| Rate for Payer: PHP Commercial |
$1,196.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.69
|
| Rate for Payer: UHC Core |
$1,175.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,055.70
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
OP
|
$2,630.58
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.76 |
| Max. Negotiated Rate |
$2,367.52 |
| Rate for Payer: Aetna Commercial |
$2,235.99
|
| Rate for Payer: Aetna Medicare |
$683.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.06
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$657.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.28
|
| Rate for Payer: BCN Commercial |
$2,045.28
|
| Rate for Payer: BCN Medicare Advantage |
$657.64
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$2,262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.64
|
| Rate for Payer: Healthscope Commercial |
$2,367.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.94
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$690.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PACE Senior Care Partners |
$624.76
|
| Rate for Payer: PACE SWMI |
$657.64
|
| Rate for Payer: PHP Commercial |
$2,235.99
|
| Rate for Payer: PHP Medicare Advantage |
$657.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.60
|
| Rate for Payer: Priority Health Medicare |
$657.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.39
|
| Rate for Payer: Railroad Medicare Medicare |
$657.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.91
|
| Rate for Payer: UHC Core |
$2,196.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.64
|
| Rate for Payer: UHC Medicare Advantage |
$677.37
|
| Rate for Payer: VA VA |
$657.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.94
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
IP
|
$2,630.58
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,604.39 |
| Max. Negotiated Rate |
$2,367.52 |
| Rate for Payer: Aetna Commercial |
$2,235.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.91
|
| Rate for Payer: BCN Commercial |
$2,032.91
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$2,262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Healthscope Commercial |
$2,367.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PHP Commercial |
$2,235.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.91
|
| Rate for Payer: UHC Core |
$2,196.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.94
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
OP
|
$2,482.79
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$589.66 |
| Max. Negotiated Rate |
$2,234.51 |
| Rate for Payer: Aetna Commercial |
$2,110.37
|
| Rate for Payer: Aetna Medicare |
$645.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$775.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$775.87
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$620.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.37
|
| Rate for Payer: BCN Commercial |
$1,930.37
|
| Rate for Payer: BCN Medicare Advantage |
$620.70
|
| Rate for Payer: Cash Price |
$1,986.23
|
| Rate for Payer: Cash Price |
$1,986.23
|
| Rate for Payer: Cofinity Commercial |
$2,135.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,986.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.70
|
| Rate for Payer: Healthscope Commercial |
$2,234.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,862.09
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$651.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$713.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,110.37
|
| Rate for Payer: PACE Senior Care Partners |
$589.66
|
| Rate for Payer: PACE SWMI |
$620.70
|
| Rate for Payer: PHP Commercial |
$2,110.37
|
| Rate for Payer: PHP Medicare Advantage |
$620.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.03
|
| Rate for Payer: Priority Health Medicare |
$620.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.25
|
| Rate for Payer: Railroad Medicare Medicare |
$620.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,184.86
|
| Rate for Payer: UHC Core |
$2,073.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.70
|
| Rate for Payer: UHC Medicare Advantage |
$639.32
|
| Rate for Payer: VA VA |
$620.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,862.09
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,482.79
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,514.25 |
| Max. Negotiated Rate |
$2,234.51 |
| Rate for Payer: Aetna Commercial |
$2,110.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.70
|
| Rate for Payer: BCN Commercial |
$1,918.70
|
| Rate for Payer: Cash Price |
$1,986.23
|
| Rate for Payer: Cofinity Commercial |
$2,135.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,986.23
|
| Rate for Payer: Healthscope Commercial |
$2,234.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,862.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,110.37
|
| Rate for Payer: PHP Commercial |
$2,110.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,184.86
|
| Rate for Payer: UHC Core |
$2,073.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,862.09
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,482.79
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$589.66 |
| Max. Negotiated Rate |
$2,234.51 |
| Rate for Payer: Aetna Commercial |
$2,110.37
|
| Rate for Payer: Aetna Medicare |
$645.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$775.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$775.87
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$620.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.37
|
| Rate for Payer: BCN Commercial |
$1,930.37
|
| Rate for Payer: BCN Medicare Advantage |
$620.70
|
| Rate for Payer: Cash Price |
$1,986.23
|
| Rate for Payer: Cash Price |
$1,986.23
|
| Rate for Payer: Cofinity Commercial |
$2,135.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,986.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$620.70
|
| Rate for Payer: Healthscope Commercial |
$2,234.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,862.09
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$651.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$713.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,110.37
|
| Rate for Payer: PACE Senior Care Partners |
$589.66
|
| Rate for Payer: PACE SWMI |
$620.70
|
| Rate for Payer: PHP Commercial |
$2,110.37
|
| Rate for Payer: PHP Medicare Advantage |
$620.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.03
|
| Rate for Payer: Priority Health Medicare |
$620.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.25
|
| Rate for Payer: Railroad Medicare Medicare |
$620.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,184.86
|
| Rate for Payer: UHC Core |
$2,073.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$620.70
|
| Rate for Payer: UHC Medicare Advantage |
$639.32
|
| Rate for Payer: VA VA |
$620.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,862.09
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,482.79
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,514.25 |
| Max. Negotiated Rate |
$2,234.51 |
| Rate for Payer: Aetna Commercial |
$2,110.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.70
|
| Rate for Payer: BCN Commercial |
$1,918.70
|
| Rate for Payer: Cash Price |
$1,986.23
|
| Rate for Payer: Cofinity Commercial |
$2,135.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,986.23
|
| Rate for Payer: Healthscope Commercial |
$2,234.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,862.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,110.37
|
| Rate for Payer: PHP Commercial |
$2,110.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,160.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,184.86
|
| Rate for Payer: UHC Core |
$2,073.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,862.09
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
IP
|
$1,044.17
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$636.84 |
| Max. Negotiated Rate |
$939.75 |
| Rate for Payer: Aetna Commercial |
$887.54
|
| Rate for Payer: BCBS Trust/PPO |
$806.93
|
| Rate for Payer: BCN Commercial |
$806.93
|
| Rate for Payer: Cash Price |
$835.34
|
| Rate for Payer: Cofinity Commercial |
$897.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.34
|
| Rate for Payer: Healthscope Commercial |
$939.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.54
|
| Rate for Payer: PHP Commercial |
$887.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.87
|
| Rate for Payer: UHC Core |
$871.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.13
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
OP
|
$1,044.17
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$247.99 |
| Max. Negotiated Rate |
$939.75 |
| Rate for Payer: Aetna Commercial |
$887.54
|
| Rate for Payer: Aetna Medicare |
$271.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.30
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$261.04
|
| Rate for Payer: BCBS Trust/PPO |
$811.84
|
| Rate for Payer: BCN Commercial |
$811.84
|
| Rate for Payer: BCN Medicare Advantage |
$261.04
|
| Rate for Payer: Cash Price |
$835.34
|
| Rate for Payer: Cash Price |
$835.34
|
| Rate for Payer: Cofinity Commercial |
$897.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.04
|
| Rate for Payer: Healthscope Commercial |
$939.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.13
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$274.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.54
|
| Rate for Payer: PACE Senior Care Partners |
$247.99
|
| Rate for Payer: PACE SWMI |
$261.04
|
| Rate for Payer: PHP Commercial |
$887.54
|
| Rate for Payer: PHP Medicare Advantage |
$261.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.43
|
| Rate for Payer: Priority Health Medicare |
$261.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.84
|
| Rate for Payer: Railroad Medicare Medicare |
$261.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.87
|
| Rate for Payer: UHC Core |
$871.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.04
|
| Rate for Payer: UHC Medicare Advantage |
$268.87
|
| Rate for Payer: VA VA |
$261.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.13
|
|
