|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
76100106
|
|
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 TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$306.31
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.75 |
| Max. Negotiated Rate |
$484.61 |
| Rate for Payer: Aetna Commercial |
$260.36
|
| Rate for Payer: Aetna Medicare |
$79.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.72
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$76.58
|
| Rate for Payer: BCBS Trust/PPO |
$238.16
|
| Rate for Payer: BCN Commercial |
$238.16
|
| Rate for Payer: BCN Medicare Advantage |
$76.58
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cofinity Commercial |
$263.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.58
|
| Rate for Payer: Healthscope Commercial |
$275.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.73
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$80.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.36
|
| Rate for Payer: PACE Senior Care Partners |
$72.75
|
| Rate for Payer: PACE SWMI |
$76.58
|
| Rate for Payer: PHP Commercial |
$260.36
|
| Rate for Payer: PHP Medicare Advantage |
$76.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.49
|
| Rate for Payer: Priority Health Medicare |
$76.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.82
|
| Rate for Payer: Railroad Medicare Medicare |
$76.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.55
|
| Rate for Payer: UHC Core |
$255.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.58
|
| Rate for Payer: UHC Medicare Advantage |
$78.87
|
| Rate for Payer: VA VA |
$76.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.73
|
|
|
HC EXCISE MALIGNANT LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$306.31
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
76100146
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.82 |
| Max. Negotiated Rate |
$275.68 |
| Rate for Payer: Aetna Commercial |
$260.36
|
| Rate for Payer: BCBS Trust/PPO |
$236.72
|
| Rate for Payer: BCN Commercial |
$236.72
|
| Rate for Payer: Cash Price |
$245.05
|
| Rate for Payer: Cofinity Commercial |
$263.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.05
|
| Rate for Payer: Healthscope Commercial |
$275.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.36
|
| Rate for Payer: PHP Commercial |
$260.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.55
|
| Rate for Payer: UHC Core |
$255.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.73
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,856.63 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: BCBS Trust/PPO |
$6,153.81
|
| Rate for Payer: BCN Commercial |
$6,153.81
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,927.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,856.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,007.44
|
| Rate for Payer: UHC Core |
$6,649.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC EXCISION/DESTRUCT LESION PHARYNX ANY METHOD
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 42808
|
| Hospital Charge Code |
76100476
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,891.21 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna Medicare |
$2,070.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,488.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,488.44
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,990.75
|
| Rate for Payer: BCBS Trust/PPO |
$6,191.23
|
| Rate for Payer: BCN Commercial |
$6,191.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,990.75
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,990.75
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,090.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,289.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PACE Senior Care Partners |
$1,891.21
|
| Rate for Payer: PACE SWMI |
$1,990.75
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,990.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,927.81
|
| Rate for Payer: Priority Health Medicare |
$1,990.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,856.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,990.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,007.44
|
| Rate for Payer: UHC Core |
$6,649.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,990.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,050.47
|
| Rate for Payer: VA VA |
$1,990.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$7,039.02
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,671.77 |
| Max. Negotiated Rate |
$6,335.12 |
| Rate for Payer: Aetna Commercial |
$5,983.17
|
| Rate for Payer: Aetna Medicare |
$1,830.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,199.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,199.69
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$1,759.76
|
| Rate for Payer: BCBS Trust/PPO |
$5,472.84
|
| Rate for Payer: BCN Commercial |
$5,472.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,759.76
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,053.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,759.76
|
| Rate for Payer: Healthscope Commercial |
$6,335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,279.26
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,847.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,023.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,983.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,671.77
|
| Rate for Payer: PACE SWMI |
$1,759.76
|
| Rate for Payer: PHP Commercial |
$5,983.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,759.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,927.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,123.95
|
| Rate for Payer: Priority Health Medicare |
$1,759.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,293.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,759.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,194.34
|
| Rate for Payer: UHC Core |
$5,877.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,759.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,812.55
|
| Rate for Payer: VA VA |
$1,759.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,279.26
|
|
|
HC EXCISION EXCESSIVE SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$7,039.02
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
76100330
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,293.10 |
| Max. Negotiated Rate |
$6,335.12 |
| Rate for Payer: Aetna Commercial |
$5,983.17
|
| Rate for Payer: BCBS Trust/PPO |
$5,439.75
|
| Rate for Payer: BCN Commercial |
$5,439.75
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,053.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Healthscope Commercial |
$6,335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,279.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,983.17
|
| Rate for Payer: PHP Commercial |
$5,983.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,927.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,123.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,293.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,194.34
|
| Rate for Payer: UHC Core |
$5,877.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,279.26
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
OP
|
$7,200.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,710.00 |
| Max. Negotiated Rate |
$6,480.00 |
| Rate for Payer: Aetna Commercial |
$6,120.00
|
| Rate for Payer: Aetna Medicare |
$1,872.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,250.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,250.00
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$1,800.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,598.00
|
| Rate for Payer: BCN Commercial |
$5,598.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,800.00
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cofinity Commercial |
$6,192.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,800.00
|
| Rate for Payer: Healthscope Commercial |
$6,480.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,400.00
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,890.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,070.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,120.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,710.00
|
| Rate for Payer: PACE SWMI |
$1,800.00
|
| Rate for Payer: PHP Commercial |
$6,120.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,800.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,040.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,264.00
|
| Rate for Payer: Priority Health Medicare |
$1,800.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,391.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,800.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,336.00
|
| Rate for Payer: UHC Core |
$6,012.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,800.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,854.00
|
| Rate for Payer: VA VA |
$1,800.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,400.00
|
|
|
HC EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR
|
Facility
|
IP
|
$7,200.00
|
|
|
Service Code
|
CPT 69110
|
| Hospital Charge Code |
76100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,391.28 |
| Max. Negotiated Rate |
$6,480.00 |
| Rate for Payer: Aetna Commercial |
$6,120.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,564.16
|
| Rate for Payer: BCN Commercial |
$5,564.16
|
| Rate for Payer: Cash Price |
$5,760.00
|
| Rate for Payer: Cofinity Commercial |
$6,192.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,760.00
|
| Rate for Payer: Healthscope Commercial |
$6,480.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,400.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,120.00
|
| Rate for Payer: PHP Commercial |
$6,120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,040.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,264.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,391.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,336.00
|
| Rate for Payer: UHC Core |
$6,012.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,400.00
|
|
|
HC EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LESION TONGUE W/O CLOSURE
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
76100465
|
|
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 EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,378.61 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna Commercial |
$3,315.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,013.92
|
| Rate for Payer: BCN Commercial |
$3,013.92
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cofinity Commercial |
$3,354.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.00
|
| Rate for Payer: Healthscope Commercial |
$3,510.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,315.00
|
| Rate for Payer: PHP Commercial |
$3,315.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,393.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,378.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,432.00
|
| Rate for Payer: UHC Core |
$3,256.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,925.00
|
|
|
HC EXCISION LINGUAL FRENUM FRENECTOMY
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
76100380
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$926.25 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Aetna Commercial |
$3,315.00
|
| Rate for Payer: Aetna Medicare |
$1,014.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,218.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,218.75
|
| Rate for Payer: BCBS Complete |
$1,050.44
|
| Rate for Payer: BCBS MAPPO |
$975.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,032.25
|
| Rate for Payer: BCN Commercial |
$3,032.25
|
| Rate for Payer: BCN Medicare Advantage |
$975.00
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cash Price |
$3,120.00
|
| Rate for Payer: Cofinity Commercial |
$3,354.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$975.00
|
| Rate for Payer: Healthscope Commercial |
$3,510.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,925.00
|
| Rate for Payer: Mclaren Medicaid |
$1,000.42
|
| Rate for Payer: Meridian Medicaid |
$1,050.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,023.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,121.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,315.00
|
| Rate for Payer: PACE Senior Care Partners |
$926.25
|
| Rate for Payer: PACE SWMI |
$975.00
|
| Rate for Payer: PHP Commercial |
$3,315.00
|
| Rate for Payer: PHP Medicare Advantage |
$975.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,730.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,393.00
|
| Rate for Payer: Priority Health Medicare |
$975.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,378.61
|
| Rate for Payer: Railroad Medicare Medicare |
$975.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,432.00
|
| Rate for Payer: UHC Core |
$3,256.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$975.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,004.25
|
| Rate for Payer: VA VA |
$975.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,925.00
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
OP
|
$7,380.33
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,752.83 |
| Max. Negotiated Rate |
$6,642.30 |
| Rate for Payer: Aetna Commercial |
$6,273.28
|
| Rate for Payer: Aetna Medicare |
$1,918.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,306.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,306.35
|
| Rate for Payer: BCBS Complete |
$1,933.98
|
| Rate for Payer: BCBS MAPPO |
$1,845.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,738.21
|
| Rate for Payer: BCN Commercial |
$5,738.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,845.08
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cofinity Commercial |
$6,347.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,904.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,845.08
|
| Rate for Payer: Healthscope Commercial |
$6,642.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,535.25
|
| Rate for Payer: Mclaren Medicaid |
$1,841.89
|
| Rate for Payer: Meridian Medicaid |
$1,933.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,937.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,121.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,273.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,752.83
|
| Rate for Payer: PACE SWMI |
$1,845.08
|
| Rate for Payer: PHP Commercial |
$6,273.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,845.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,841.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,166.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,420.89
|
| Rate for Payer: Priority Health Medicare |
$1,845.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,501.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,845.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,494.69
|
| Rate for Payer: UHC Core |
$6,162.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,845.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,900.43
|
| Rate for Payer: VA VA |
$1,845.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,535.25
|
|
|
HC EXCISION OF ANAL LESION(S)
|
Facility
|
IP
|
$7,380.33
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
76100350
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,501.26 |
| Max. Negotiated Rate |
$6,642.30 |
| Rate for Payer: Aetna Commercial |
$6,273.28
|
| Rate for Payer: BCBS Trust/PPO |
$5,703.52
|
| Rate for Payer: BCN Commercial |
$5,703.52
|
| Rate for Payer: Cash Price |
$5,904.26
|
| Rate for Payer: Cofinity Commercial |
$6,347.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,904.26
|
| Rate for Payer: Healthscope Commercial |
$6,642.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,535.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,273.28
|
| Rate for Payer: PHP Commercial |
$6,273.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,166.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,420.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,501.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,494.69
|
| Rate for Payer: UHC Core |
$6,162.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,535.25
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
IP
|
$388.03
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.66 |
| Max. Negotiated Rate |
$349.23 |
| Rate for Payer: Aetna Commercial |
$329.83
|
| Rate for Payer: BCBS Trust/PPO |
$299.87
|
| Rate for Payer: BCN Commercial |
$299.87
|
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Cofinity Commercial |
$333.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.42
|
| Rate for Payer: Healthscope Commercial |
$349.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$329.83
|
| Rate for Payer: PHP Commercial |
$329.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$271.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.47
|
| Rate for Payer: UHC Core |
$324.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.02
|
|
|
HC EXCISION OF NAIL OR NAIL MATRIX
|
Facility
|
OP
|
$388.03
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
76100077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.16 |
| Max. Negotiated Rate |
$349.23 |
| Rate for Payer: Aetna Commercial |
$329.83
|
| Rate for Payer: Aetna Medicare |
$100.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.26
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$97.01
|
| Rate for Payer: BCBS Trust/PPO |
$301.69
|
| Rate for Payer: BCN Commercial |
$301.69
|
| Rate for Payer: BCN Medicare Advantage |
$97.01
|
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Cofinity Commercial |
$333.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.01
|
| Rate for Payer: Healthscope Commercial |
$349.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.02
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$101.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$329.83
|
| Rate for Payer: PACE Senior Care Partners |
$92.16
|
| Rate for Payer: PACE SWMI |
$97.01
|
| Rate for Payer: PHP Commercial |
$329.83
|
| Rate for Payer: PHP Medicare Advantage |
$97.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$271.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.59
|
| Rate for Payer: Priority Health Medicare |
$97.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.66
|
| Rate for Payer: Railroad Medicare Medicare |
$97.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.47
|
| Rate for Payer: UHC Core |
$324.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.01
|
| Rate for Payer: UHC Medicare Advantage |
$99.92
|
| Rate for Payer: VA VA |
$97.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.02
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,174.31
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$3,155.81 |
| Max. Negotiated Rate |
$4,656.88 |
| Rate for Payer: Aetna Commercial |
$4,398.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,998.71
|
| Rate for Payer: BCN Commercial |
$3,998.71
|
| Rate for Payer: Cash Price |
$4,139.45
|
| Rate for Payer: Cofinity Commercial |
$4,449.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,139.45
|
| Rate for Payer: Healthscope Commercial |
$4,656.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,880.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,398.16
|
| Rate for Payer: PHP Commercial |
$4,398.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,622.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,501.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,155.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,553.39
|
| Rate for Payer: UHC Core |
$4,320.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,880.73
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$5,174.31
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$1,196.28 |
| Max. Negotiated Rate |
$4,656.88 |
| Rate for Payer: Aetna Commercial |
$4,398.16
|
| Rate for Payer: Aetna Medicare |
$1,345.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,616.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,616.97
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$1,293.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,023.03
|
| Rate for Payer: BCN Commercial |
$4,023.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,293.58
|
| Rate for Payer: Cash Price |
$4,139.45
|
| Rate for Payer: Cash Price |
$4,139.45
|
| Rate for Payer: Cofinity Commercial |
$4,449.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,139.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,293.58
|
| Rate for Payer: Healthscope Commercial |
$4,656.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,880.73
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,358.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,487.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,398.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,228.90
|
| Rate for Payer: PACE SWMI |
$1,293.58
|
| Rate for Payer: PHP Commercial |
$4,398.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,293.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,622.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,501.65
|
| Rate for Payer: Priority Health Medicare |
$1,293.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,155.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,293.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,553.39
|
| Rate for Payer: UHC Core |
$4,320.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,293.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,332.38
|
| Rate for Payer: VA VA |
$1,293.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,880.73
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
OP
|
$3,867.86
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$918.62 |
| Max. Negotiated Rate |
$3,481.07 |
| Rate for Payer: Aetna Commercial |
$3,287.68
|
| Rate for Payer: Aetna Medicare |
$1,005.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,208.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,208.71
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$966.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,007.26
|
| Rate for Payer: BCN Commercial |
$3,007.26
|
| Rate for Payer: BCN Medicare Advantage |
$966.96
|
| Rate for Payer: Cash Price |
$3,094.29
|
| Rate for Payer: Cash Price |
$3,094.29
|
| Rate for Payer: Cofinity Commercial |
$3,326.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,094.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$966.96
|
| Rate for Payer: Healthscope Commercial |
$3,481.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,900.90
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,015.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,112.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,287.68
|
| Rate for Payer: PACE Senior Care Partners |
$918.62
|
| Rate for Payer: PACE SWMI |
$966.96
|
| Rate for Payer: PHP Commercial |
$3,287.68
|
| Rate for Payer: PHP Medicare Advantage |
$966.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,707.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,365.04
|
| Rate for Payer: Priority Health Medicare |
$966.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,359.01
|
| Rate for Payer: Railroad Medicare Medicare |
$966.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,403.72
|
| Rate for Payer: UHC Core |
$3,229.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$966.96
|
| Rate for Payer: UHC Medicare Advantage |
$995.97
|
| Rate for Payer: VA VA |
$966.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,900.90
|
|
|
HC EXCISION PILONIDAL CYST/SINUS SIMPLE
|
Facility
|
IP
|
$3,867.86
|
|
|
Service Code
|
CPT 11770
|
| Hospital Charge Code |
76100321
|
| Min. Negotiated Rate |
$2,359.01 |
| Max. Negotiated Rate |
$3,481.07 |
| Rate for Payer: Aetna Commercial |
$3,287.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,989.08
|
| Rate for Payer: BCN Commercial |
$2,989.08
|
| Rate for Payer: Cash Price |
$3,094.29
|
| Rate for Payer: Cofinity Commercial |
$3,326.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,094.29
|
| Rate for Payer: Healthscope Commercial |
$3,481.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,900.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,287.68
|
| Rate for Payer: PHP Commercial |
$3,287.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,707.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,365.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,359.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,403.72
|
| Rate for Payer: UHC Core |
$3,229.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,900.90
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
IP
|
$7,022.49
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,283.02 |
| Max. Negotiated Rate |
$6,320.24 |
| Rate for Payer: Aetna Commercial |
$5,969.12
|
| Rate for Payer: BCBS Trust/PPO |
$5,426.98
|
| Rate for Payer: BCN Commercial |
$5,426.98
|
| Rate for Payer: Cash Price |
$5,617.99
|
| Rate for Payer: Cofinity Commercial |
$6,039.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,617.99
|
| Rate for Payer: Healthscope Commercial |
$6,320.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,266.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,969.12
|
| Rate for Payer: PHP Commercial |
$5,969.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,915.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,109.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,283.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,179.79
|
| Rate for Payer: UHC Core |
$5,863.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,266.87
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
OP
|
$7,022.49
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,667.84 |
| Max. Negotiated Rate |
$6,320.24 |
| Rate for Payer: Aetna Commercial |
$5,969.12
|
| Rate for Payer: Aetna Medicare |
$1,825.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,194.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,194.53
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$1,755.62
|
| Rate for Payer: BCBS Trust/PPO |
$5,459.99
|
| Rate for Payer: BCN Commercial |
$5,459.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,755.62
|
| Rate for Payer: Cash Price |
$5,617.99
|
| Rate for Payer: Cash Price |
$5,617.99
|
| Rate for Payer: Cofinity Commercial |
$6,039.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,617.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,755.62
|
| Rate for Payer: Healthscope Commercial |
$6,320.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,266.87
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,843.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,018.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,969.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,667.84
|
| Rate for Payer: PACE SWMI |
$1,755.62
|
| Rate for Payer: PHP Commercial |
$5,969.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,755.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,915.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,109.57
|
| Rate for Payer: Priority Health Medicare |
$1,755.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,283.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,755.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,179.79
|
| Rate for Payer: UHC Core |
$5,863.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,755.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,808.29
|
| Rate for Payer: VA VA |
$1,755.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,266.87
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,891.21 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna Medicare |
$2,070.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,488.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,488.44
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,990.75
|
| Rate for Payer: BCBS Trust/PPO |
$6,191.23
|
| Rate for Payer: BCN Commercial |
$6,191.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,990.75
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,990.75
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,090.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,289.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PACE Senior Care Partners |
$1,891.21
|
| Rate for Payer: PACE SWMI |
$1,990.75
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,990.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,927.81
|
| Rate for Payer: Priority Health Medicare |
$1,990.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,856.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,990.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,007.44
|
| Rate for Payer: UHC Core |
$6,649.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,990.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,050.47
|
| Rate for Payer: VA VA |
$1,990.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,856.63 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: BCBS Trust/PPO |
$6,153.81
|
| Rate for Payer: BCN Commercial |
$6,153.81
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,927.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,856.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,007.44
|
| Rate for Payer: UHC Core |
$6,649.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
