|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$384.54
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
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 DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$384.54
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
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 DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$215.22
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.26 |
| Max. Negotiated Rate |
$193.70 |
| Rate for Payer: Aetna Commercial |
$182.94
|
| Rate for Payer: BCBS Trust/PPO |
$166.32
|
| Rate for Payer: BCN Commercial |
$166.32
|
| Rate for Payer: Cash Price |
$172.18
|
| Rate for Payer: Cofinity Commercial |
$185.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.18
|
| Rate for Payer: Healthscope Commercial |
$193.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.94
|
| Rate for Payer: PHP Commercial |
$182.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.39
|
| Rate for Payer: UHC Core |
$179.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.42
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$215.22
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$51.11 |
| Max. Negotiated Rate |
$193.70 |
| Rate for Payer: Aetna Commercial |
$182.94
|
| Rate for Payer: Aetna Medicare |
$55.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.26
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$53.80
|
| Rate for Payer: BCBS Trust/PPO |
$167.33
|
| Rate for Payer: BCN Commercial |
$167.33
|
| Rate for Payer: BCN Medicare Advantage |
$53.80
|
| Rate for Payer: Cash Price |
$172.18
|
| Rate for Payer: Cash Price |
$172.18
|
| Rate for Payer: Cofinity Commercial |
$185.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.80
|
| Rate for Payer: Healthscope Commercial |
$193.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.42
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.94
|
| Rate for Payer: PACE Senior Care Partners |
$51.11
|
| Rate for Payer: PACE SWMI |
$53.80
|
| Rate for Payer: PHP Commercial |
$182.94
|
| Rate for Payer: PHP Medicare Advantage |
$53.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.24
|
| Rate for Payer: Priority Health Medicare |
$53.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.26
|
| Rate for Payer: Railroad Medicare Medicare |
$53.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.39
|
| Rate for Payer: UHC Core |
$179.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.80
|
| Rate for Payer: UHC Medicare Advantage |
$55.42
|
| Rate for Payer: VA VA |
$53.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.42
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
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 MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
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 MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$303.68
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$258.13
|
| Rate for Payer: Aetna Medicare |
$78.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.90
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$75.92
|
| Rate for Payer: BCBS Trust/PPO |
$236.11
|
| Rate for Payer: BCN Commercial |
$236.11
|
| Rate for Payer: BCN Medicare Advantage |
$75.92
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.92
|
| Rate for Payer: Healthscope Commercial |
$273.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.76
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.13
|
| Rate for Payer: PACE Senior Care Partners |
$72.12
|
| Rate for Payer: PACE SWMI |
$75.92
|
| Rate for Payer: PHP Commercial |
$258.13
|
| Rate for Payer: PHP Medicare Advantage |
$75.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.20
|
| Rate for Payer: Priority Health Medicare |
$75.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.21
|
| Rate for Payer: Railroad Medicare Medicare |
$75.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.24
|
| Rate for Payer: UHC Core |
$253.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.92
|
| Rate for Payer: UHC Medicare Advantage |
$78.20
|
| Rate for Payer: VA VA |
$75.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.76
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$303.68
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.21 |
| Max. Negotiated Rate |
$273.31 |
| Rate for Payer: Aetna Commercial |
$258.13
|
| Rate for Payer: BCBS Trust/PPO |
$234.68
|
| Rate for Payer: BCN Commercial |
$234.68
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.94
|
| Rate for Payer: Healthscope Commercial |
$273.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.13
|
| Rate for Payer: PHP Commercial |
$258.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.24
|
| Rate for Payer: UHC Core |
$253.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.76
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$158.65
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$158.65
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$522.00
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.37 |
| Max. Negotiated Rate |
$469.80 |
| Rate for Payer: Aetna Commercial |
$443.70
|
| Rate for Payer: BCBS Trust/PPO |
$403.40
|
| Rate for Payer: BCN Commercial |
$403.40
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cofinity Commercial |
$448.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$417.60
|
| Rate for Payer: Healthscope Commercial |
$469.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$443.70
|
| Rate for Payer: PHP Commercial |
$443.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.36
|
| Rate for Payer: UHC Core |
$435.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.50
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$522.00
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.98 |
| Max. Negotiated Rate |
$469.80 |
| Rate for Payer: Aetna Commercial |
$443.70
|
| Rate for Payer: Aetna Medicare |
$135.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.12
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$130.50
|
| Rate for Payer: BCBS Trust/PPO |
$405.86
|
| Rate for Payer: BCN Commercial |
$405.86
|
| Rate for Payer: BCN Medicare Advantage |
$130.50
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cofinity Commercial |
$448.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$417.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.50
|
| Rate for Payer: Healthscope Commercial |
$469.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.50
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$443.70
|
| Rate for Payer: PACE Senior Care Partners |
$123.98
|
| Rate for Payer: PACE SWMI |
$130.50
|
| Rate for Payer: PHP Commercial |
$443.70
|
| Rate for Payer: PHP Medicare Advantage |
$130.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.14
|
| Rate for Payer: Priority Health Medicare |
$130.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.37
|
| Rate for Payer: Railroad Medicare Medicare |
$130.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$459.36
|
| Rate for Payer: UHC Core |
$435.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.50
|
| Rate for Payer: UHC Medicare Advantage |
$134.42
|
| Rate for Payer: VA VA |
$130.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.50
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
OP
|
$400.86
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$360.77 |
| Rate for Payer: Aetna Commercial |
$340.73
|
| Rate for Payer: Aetna Medicare |
$104.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.27
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$100.22
|
| Rate for Payer: BCBS Trust/PPO |
$311.67
|
| Rate for Payer: BCN Commercial |
$311.67
|
| Rate for Payer: BCN Medicare Advantage |
$100.22
|
| Rate for Payer: Cash Price |
$320.69
|
| Rate for Payer: Cash Price |
$320.69
|
| Rate for Payer: Cofinity Commercial |
$344.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.22
|
| Rate for Payer: Healthscope Commercial |
$360.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.64
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.73
|
| Rate for Payer: PACE Senior Care Partners |
$95.20
|
| Rate for Payer: PACE SWMI |
$100.22
|
| Rate for Payer: PHP Commercial |
$340.73
|
| Rate for Payer: PHP Medicare Advantage |
$100.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.75
|
| Rate for Payer: Priority Health Medicare |
$100.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.48
|
| Rate for Payer: Railroad Medicare Medicare |
$100.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.76
|
| Rate for Payer: UHC Core |
$334.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.22
|
| Rate for Payer: UHC Medicare Advantage |
$103.22
|
| Rate for Payer: VA VA |
$100.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.64
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
IP
|
$400.86
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.48 |
| Max. Negotiated Rate |
$360.77 |
| Rate for Payer: Aetna Commercial |
$340.73
|
| Rate for Payer: BCBS Trust/PPO |
$309.78
|
| Rate for Payer: BCN Commercial |
$309.78
|
| Rate for Payer: Cash Price |
$320.69
|
| Rate for Payer: Cofinity Commercial |
$344.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.69
|
| Rate for Payer: Healthscope Commercial |
$360.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.73
|
| Rate for Payer: PHP Commercial |
$340.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.76
|
| Rate for Payer: UHC Core |
$334.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.64
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
OP
|
$173.07
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
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 PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
IP
|
$173.07
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
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 PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
OP
|
$34.78
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Aetna Commercial |
$29.56
|
| Rate for Payer: Aetna Medicare |
$9.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.87
|
| Rate for Payer: BCBS Complete |
$13.91
|
| Rate for Payer: BCBS MAPPO |
$8.70
|
| Rate for Payer: BCBS Trust/PPO |
$27.04
|
| Rate for Payer: BCN Commercial |
$27.04
|
| Rate for Payer: BCN Medicare Advantage |
$8.70
|
| Rate for Payer: Cash Price |
$27.82
|
| Rate for Payer: Cofinity Commercial |
$29.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.70
|
| Rate for Payer: Healthscope Commercial |
$31.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.56
|
| Rate for Payer: PACE Senior Care Partners |
$8.26
|
| Rate for Payer: PACE SWMI |
$8.70
|
| Rate for Payer: PHP Commercial |
$29.56
|
| Rate for Payer: PHP Medicare Advantage |
$8.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.26
|
| Rate for Payer: Priority Health Medicare |
$8.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.21
|
| Rate for Payer: Railroad Medicare Medicare |
$8.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.61
|
| Rate for Payer: UHC Core |
$29.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.70
|
| Rate for Payer: UHC Medicare Advantage |
$8.96
|
| Rate for Payer: VA VA |
$8.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.08
|
|
