|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,077.30
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$493.36 |
| Max. Negotiated Rate |
$1,869.57 |
| Rate for Payer: Aetna Commercial |
$1,765.70
|
| Rate for Payer: Aetna Medicare |
$540.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.16
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$519.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,615.10
|
| Rate for Payer: BCN Commercial |
$1,615.10
|
| Rate for Payer: BCN Medicare Advantage |
$519.32
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cofinity Commercial |
$1,786.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,661.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.32
|
| Rate for Payer: Healthscope Commercial |
$1,869.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,557.98
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$545.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,765.70
|
| Rate for Payer: PACE Senior Care Partners |
$493.36
|
| Rate for Payer: PACE SWMI |
$519.32
|
| Rate for Payer: PHP Commercial |
$1,765.70
|
| Rate for Payer: PHP Medicare Advantage |
$519.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,807.25
|
| Rate for Payer: Priority Health Medicare |
$519.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,266.95
|
| Rate for Payer: Railroad Medicare Medicare |
$519.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,828.02
|
| Rate for Payer: UHC Core |
$1,734.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.32
|
| Rate for Payer: UHC Medicare Advantage |
$534.90
|
| Rate for Payer: VA VA |
$519.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,557.98
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,077.30
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,266.95 |
| Max. Negotiated Rate |
$1,869.57 |
| Rate for Payer: Aetna Commercial |
$1,765.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,605.34
|
| Rate for Payer: BCN Commercial |
$1,605.34
|
| Rate for Payer: Cash Price |
$1,661.84
|
| Rate for Payer: Cofinity Commercial |
$1,786.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,661.84
|
| Rate for Payer: Healthscope Commercial |
$1,869.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,557.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,765.70
|
| Rate for Payer: PHP Commercial |
$1,765.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,807.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,266.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,828.02
|
| Rate for Payer: UHC Core |
$1,734.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,557.98
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,635.22
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$559.44 |
| Max. Negotiated Rate |
$4,171.70 |
| Rate for Payer: Aetna Commercial |
$3,939.94
|
| Rate for Payer: Aetna Medicare |
$1,205.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,448.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,448.51
|
| Rate for Payer: BCBS Complete |
$2,625.49
|
| Rate for Payer: BCBS MAPPO |
$1,158.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,603.88
|
| Rate for Payer: BCCCP Commercial |
$559.44
|
| Rate for Payer: BCN Commercial |
$3,603.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,158.80
|
| Rate for Payer: Cash Price |
$3,708.18
|
| Rate for Payer: Cash Price |
$3,708.18
|
| Rate for Payer: Cofinity Commercial |
$3,986.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,708.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,158.80
|
| Rate for Payer: Healthscope Commercial |
$4,171.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,476.42
|
| Rate for Payer: Mclaren Medicaid |
$2,500.47
|
| Rate for Payer: Meridian Medicaid |
$2,625.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,216.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,332.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,939.94
|
| Rate for Payer: PACE Senior Care Partners |
$1,100.86
|
| Rate for Payer: PACE SWMI |
$1,158.80
|
| Rate for Payer: PHP Commercial |
$3,939.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,158.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,500.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,244.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,032.64
|
| Rate for Payer: Priority Health Medicare |
$1,158.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,827.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,158.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,078.99
|
| Rate for Payer: UHC Core |
$3,870.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,158.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,193.57
|
| Rate for Payer: VA VA |
$1,158.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,476.42
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,635.22
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,827.02 |
| Max. Negotiated Rate |
$4,171.70 |
| Rate for Payer: Aetna Commercial |
$3,939.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,582.10
|
| Rate for Payer: BCN Commercial |
$3,582.10
|
| Rate for Payer: Cash Price |
$3,708.18
|
| Rate for Payer: Cofinity Commercial |
$3,986.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,708.18
|
| Rate for Payer: Healthscope Commercial |
$4,171.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,476.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,939.94
|
| Rate for Payer: PHP Commercial |
$3,939.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,244.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,032.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,827.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,078.99
|
| Rate for Payer: UHC Core |
$3,870.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,476.42
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$852.77
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$520.10 |
| Max. Negotiated Rate |
$767.49 |
| Rate for Payer: Aetna Commercial |
$724.85
|
| Rate for Payer: BCBS Trust/PPO |
$659.02
|
| Rate for Payer: BCN Commercial |
$659.02
|
| Rate for Payer: Cash Price |
$682.22
|
| Rate for Payer: Cofinity Commercial |
$733.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.22
|
| Rate for Payer: Healthscope Commercial |
$767.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$639.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$724.85
|
| Rate for Payer: PHP Commercial |
$724.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$741.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$520.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$750.44
|
| Rate for Payer: UHC Core |
$712.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$639.58
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$852.77
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.53 |
| Max. Negotiated Rate |
$767.49 |
| Rate for Payer: Aetna Commercial |
$724.85
|
| Rate for Payer: Aetna Medicare |
$221.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$266.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$266.49
|
| Rate for Payer: BCBS Complete |
$697.36
|
| Rate for Payer: BCBS MAPPO |
$213.19
|
| Rate for Payer: BCBS Trust/PPO |
$663.03
|
| Rate for Payer: BCN Commercial |
$663.03
|
| Rate for Payer: BCN Medicare Advantage |
$213.19
|
| Rate for Payer: Cash Price |
$682.22
|
| Rate for Payer: Cash Price |
$682.22
|
| Rate for Payer: Cofinity Commercial |
$733.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.19
|
| Rate for Payer: Healthscope Commercial |
$767.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$639.58
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Medicaid |
$697.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$223.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$245.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$724.85
|
| Rate for Payer: PACE Senior Care Partners |
$202.53
|
| Rate for Payer: PACE SWMI |
$213.19
|
| Rate for Payer: PHP Commercial |
$724.85
|
| Rate for Payer: PHP Medicare Advantage |
$213.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$741.91
|
| Rate for Payer: Priority Health Medicare |
$213.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$520.10
|
| Rate for Payer: Railroad Medicare Medicare |
$213.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$750.44
|
| Rate for Payer: UHC Core |
$712.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.19
|
| Rate for Payer: UHC Medicare Advantage |
$219.59
|
| Rate for Payer: VA VA |
$213.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$639.58
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,818.21 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,105.12
|
| Rate for Payer: BCN Commercial |
$6,105.12
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,876.25 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,054.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,468.75
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,975.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,142.25
|
| Rate for Payer: BCN Commercial |
$6,142.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,975.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,975.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,073.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,271.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,876.25
|
| Rate for Payer: PACE SWMI |
$1,975.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,975.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Medicare |
$1,975.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,975.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,975.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,034.25
|
| Rate for Payer: VA VA |
$1,975.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,876.25 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,054.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,468.75
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,975.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,142.25
|
| Rate for Payer: BCN Commercial |
$6,142.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,975.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,975.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,073.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,271.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,876.25
|
| Rate for Payer: PACE SWMI |
$1,975.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,975.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Medicare |
$1,975.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,975.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,975.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,034.25
|
| Rate for Payer: VA VA |
$1,975.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,818.21 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,105.12
|
| Rate for Payer: BCN Commercial |
$6,105.12
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$3,886.79
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$923.11 |
| Max. Negotiated Rate |
$3,498.11 |
| Rate for Payer: Aetna Commercial |
$3,303.77
|
| Rate for Payer: Aetna Medicare |
$1,010.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,214.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,214.62
|
| Rate for Payer: BCBS Complete |
$1,050.44
|
| Rate for Payer: BCBS MAPPO |
$971.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,021.98
|
| Rate for Payer: BCN Commercial |
$3,021.98
|
| Rate for Payer: BCN Medicare Advantage |
$971.70
|
| Rate for Payer: Cash Price |
$3,109.43
|
| Rate for Payer: Cash Price |
$3,109.43
|
| Rate for Payer: Cofinity Commercial |
$3,342.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,109.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$971.70
|
| Rate for Payer: Healthscope Commercial |
$3,498.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,915.09
|
| Rate for Payer: Mclaren Medicaid |
$1,000.42
|
| Rate for Payer: Meridian Medicaid |
$1,050.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,020.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,117.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,303.77
|
| Rate for Payer: PACE Senior Care Partners |
$923.11
|
| Rate for Payer: PACE SWMI |
$971.70
|
| Rate for Payer: PHP Commercial |
$3,303.77
|
| Rate for Payer: PHP Medicare Advantage |
$971.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,381.51
|
| Rate for Payer: Priority Health Medicare |
$971.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,370.55
|
| Rate for Payer: Railroad Medicare Medicare |
$971.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,420.38
|
| Rate for Payer: UHC Core |
$3,245.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$971.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,000.85
|
| Rate for Payer: VA VA |
$971.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,915.09
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
IP
|
$3,886.79
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,370.55 |
| Max. Negotiated Rate |
$3,498.11 |
| Rate for Payer: Aetna Commercial |
$3,303.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,003.71
|
| Rate for Payer: BCN Commercial |
$3,003.71
|
| Rate for Payer: Cash Price |
$3,109.43
|
| Rate for Payer: Cofinity Commercial |
$3,342.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,109.43
|
| Rate for Payer: Healthscope Commercial |
$3,498.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,915.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,303.77
|
| Rate for Payer: PHP Commercial |
$3,303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,720.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,381.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,370.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,420.38
|
| Rate for Payer: UHC Core |
$3,245.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,915.09
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
OP
|
$185.64
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$484.61 |
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: Aetna Medicare |
$48.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.01
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$46.41
|
| Rate for Payer: BCBS Trust/PPO |
$144.34
|
| Rate for Payer: BCN Commercial |
$144.34
|
| Rate for Payer: BCN Medicare Advantage |
$46.41
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.41
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.79
|
| Rate for Payer: PACE Senior Care Partners |
$44.09
|
| Rate for Payer: PACE SWMI |
$46.41
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: PHP Medicare Advantage |
$46.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.51
|
| Rate for Payer: Priority Health Medicare |
$46.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.22
|
| Rate for Payer: Railroad Medicare Medicare |
$46.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.36
|
| Rate for Payer: UHC Core |
$155.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.41
|
| Rate for Payer: UHC Medicare Advantage |
$47.80
|
| Rate for Payer: VA VA |
$46.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS <=0.5 CM
|
Facility
|
IP
|
$185.64
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
76100145
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.22 |
| Max. Negotiated Rate |
$167.08 |
| Rate for Payer: Aetna Commercial |
$157.79
|
| Rate for Payer: BCBS Trust/PPO |
$143.46
|
| Rate for Payer: BCN Commercial |
$143.46
|
| Rate for Payer: Cash Price |
$148.51
|
| Rate for Payer: Cofinity Commercial |
$159.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.51
|
| Rate for Payer: Healthscope Commercial |
$167.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.79
|
| Rate for Payer: PHP Commercial |
$157.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.36
|
| Rate for Payer: UHC Core |
$155.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
76100104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
76100105
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
