|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,850.06 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,025.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,434.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,434.29
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,947.44
|
| Rate for Payer: BCBS Trust/PPO |
$6,056.52
|
| Rate for Payer: BCN Commercial |
$6,056.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,947.44
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,947.44
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,044.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,239.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,850.06
|
| Rate for Payer: PACE SWMI |
$1,947.44
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,947.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Medicare |
$1,947.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,947.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,947.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,005.86
|
| Rate for Payer: VA VA |
$1,947.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,750.96 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,019.91
|
| Rate for Payer: BCN Commercial |
$6,019.91
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
OP
|
$2,870.28
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$681.69 |
| Max. Negotiated Rate |
$2,583.25 |
| Rate for Payer: Aetna Commercial |
$2,439.74
|
| Rate for Payer: Aetna Medicare |
$746.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$896.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$896.96
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$717.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,231.64
|
| Rate for Payer: BCN Commercial |
$2,231.64
|
| Rate for Payer: BCN Medicare Advantage |
$717.57
|
| Rate for Payer: Cash Price |
$2,296.22
|
| Rate for Payer: Cash Price |
$2,296.22
|
| Rate for Payer: Cofinity Commercial |
$2,468.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,296.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.57
|
| Rate for Payer: Healthscope Commercial |
$2,583.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,152.71
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$753.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$825.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,439.74
|
| Rate for Payer: PACE Senior Care Partners |
$681.69
|
| Rate for Payer: PACE SWMI |
$717.57
|
| Rate for Payer: PHP Commercial |
$2,439.74
|
| Rate for Payer: PHP Medicare Advantage |
$717.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,009.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,497.14
|
| Rate for Payer: Priority Health Medicare |
$717.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,750.58
|
| Rate for Payer: Railroad Medicare Medicare |
$717.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,525.85
|
| Rate for Payer: UHC Core |
$2,396.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.57
|
| Rate for Payer: UHC Medicare Advantage |
$739.10
|
| Rate for Payer: VA VA |
$717.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,152.71
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
IP
|
$2,870.28
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,750.58 |
| Max. Negotiated Rate |
$2,583.25 |
| Rate for Payer: Aetna Commercial |
$2,439.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,218.15
|
| Rate for Payer: BCN Commercial |
$2,218.15
|
| Rate for Payer: Cash Price |
$2,296.22
|
| Rate for Payer: Cofinity Commercial |
$2,468.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,296.22
|
| Rate for Payer: Healthscope Commercial |
$2,583.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,152.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,439.74
|
| Rate for Payer: PHP Commercial |
$2,439.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,009.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,497.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,750.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,525.85
|
| Rate for Payer: UHC Core |
$2,396.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,152.71
|
|
|
HC EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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 EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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 EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,116.73 |
| 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 |
$1,116.73
|
| 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 |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| 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 |
$1,063.55
|
| 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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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 EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
IP
|
$1,536.46
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$937.09 |
| Max. Negotiated Rate |
$1,382.81 |
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.38
|
| Rate for Payer: BCN Commercial |
$1,187.38
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.08
|
| Rate for Payer: UHC Core |
$1,282.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC EXC SINGLE EXTERNAL PAPILLA OR TAG, ANUS
|
Facility
|
OP
|
$1,536.46
|
|
|
Service Code
|
CPT 46220
|
| Hospital Charge Code |
76100280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$364.91 |
| Max. Negotiated Rate |
$1,382.81 |
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: Aetna Medicare |
$399.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.14
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$384.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.60
|
| Rate for Payer: BCN Commercial |
$1,194.60
|
| Rate for Payer: BCN Medicare Advantage |
$384.12
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.12
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PACE Senior Care Partners |
$364.91
|
| Rate for Payer: PACE SWMI |
$384.12
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: PHP Medicare Advantage |
$384.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.72
|
| Rate for Payer: Priority Health Medicare |
$384.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.09
|
| Rate for Payer: Railroad Medicare Medicare |
$384.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.08
|
| Rate for Payer: UHC Core |
$1,282.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.12
|
| Rate for Payer: UHC Medicare Advantage |
$395.64
|
| Rate for Payer: VA VA |
$384.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,283.55 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.37
|
| Rate for Payer: BCN Commercial |
$1,626.37
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 2.1-3CM FACE, FACIAL
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11643
|
| Hospital Charge Code |
76100215
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$499.82 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$547.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$657.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$657.66
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$526.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.26
|
| Rate for Payer: BCN Commercial |
$1,636.26
|
| Rate for Payer: BCN Medicare Advantage |
$526.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$605.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Senior Care Partners |
$499.82
|
| Rate for Payer: PACE SWMI |
$526.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$526.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Medicare |
$526.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: Railroad Medicare Medicare |
$526.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.13
|
| Rate for Payer: UHC Medicare Advantage |
$541.91
|
| Rate for Payer: VA VA |
$526.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$499.82 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$547.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$657.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$657.66
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$526.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.26
|
| Rate for Payer: BCN Commercial |
$1,636.26
|
| Rate for Payer: BCN Medicare Advantage |
$526.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$605.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Senior Care Partners |
$499.82
|
| Rate for Payer: PACE SWMI |
$526.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$526.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Medicare |
$526.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: Railroad Medicare Medicare |
$526.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.13
|
| Rate for Payer: UHC Medicare Advantage |
$541.91
|
| Rate for Payer: VA VA |
$526.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 2.1-3 CM REMAINDER BODY
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
76100212
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,283.55 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.37
|
| Rate for Payer: BCN Commercial |
$1,626.37
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,283.55 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.37
|
| Rate for Payer: BCN Commercial |
$1,626.37
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4CM FACE, FACIAL
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11644
|
| Hospital Charge Code |
76100216
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$499.82 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$547.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$657.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$657.66
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$526.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.26
|
| Rate for Payer: BCN Commercial |
$1,636.26
|
| Rate for Payer: BCN Medicare Advantage |
$526.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$605.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Senior Care Partners |
$499.82
|
| Rate for Payer: PACE SWMI |
$526.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$526.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Medicare |
$526.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: Railroad Medicare Medicare |
$526.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.13
|
| Rate for Payer: UHC Medicare Advantage |
$541.91
|
| Rate for Payer: VA VA |
$526.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
OP
|
$2,104.52
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$499.82 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: Aetna Medicare |
$547.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$657.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$657.66
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$526.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.26
|
| Rate for Payer: BCN Commercial |
$1,636.26
|
| Rate for Payer: BCN Medicare Advantage |
$526.13
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.13
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$552.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$605.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PACE Senior Care Partners |
$499.82
|
| Rate for Payer: PACE SWMI |
$526.13
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: PHP Medicare Advantage |
$526.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Medicare |
$526.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: Railroad Medicare Medicare |
$526.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$526.13
|
| Rate for Payer: UHC Medicare Advantage |
$541.91
|
| Rate for Payer: VA VA |
$526.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG 3.1-4 CM REMAINDER BODY
|
Facility
|
IP
|
$2,104.52
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
76100213
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,283.55 |
| Max. Negotiated Rate |
$1,894.07 |
| Rate for Payer: Aetna Commercial |
$1,788.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.37
|
| Rate for Payer: BCN Commercial |
$1,626.37
|
| Rate for Payer: Cash Price |
$1,683.62
|
| Rate for Payer: Cofinity Commercial |
$1,809.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.62
|
| Rate for Payer: Healthscope Commercial |
$1,894.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.84
|
| Rate for Payer: PHP Commercial |
$1,788.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,830.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,283.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,851.98
|
| Rate for Payer: UHC Core |
$1,757.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.39
|
|
|
HC EXC SKIN MALIG >4CM FACE, FACIAL
|
Facility
|
OP
|
$3,638.85
|
|
|
Service Code
|
CPT 11646
|
| Hospital Charge Code |
76100217
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$864.23 |
| Max. Negotiated Rate |
$3,274.96 |
| Rate for Payer: Aetna Commercial |
$3,093.02
|
| Rate for Payer: Aetna Medicare |
$946.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,137.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,137.14
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$909.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,829.21
|
| Rate for Payer: BCN Commercial |
$2,829.21
|
| Rate for Payer: BCN Medicare Advantage |
$909.71
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cash Price |
$2,911.08
|
| Rate for Payer: Cofinity Commercial |
$3,129.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,911.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$909.71
|
| Rate for Payer: Healthscope Commercial |
$3,274.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,729.14
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$955.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,046.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,093.02
|
| Rate for Payer: PACE Senior Care Partners |
$864.23
|
| Rate for Payer: PACE SWMI |
$909.71
|
| Rate for Payer: PHP Commercial |
$3,093.02
|
| Rate for Payer: PHP Medicare Advantage |
$909.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,547.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,165.80
|
| Rate for Payer: Priority Health Medicare |
$909.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,219.33
|
| Rate for Payer: Railroad Medicare Medicare |
$909.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,202.19
|
| Rate for Payer: UHC Core |
$3,038.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$909.71
|
| Rate for Payer: UHC Medicare Advantage |
$937.00
|
| Rate for Payer: VA VA |
$909.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,729.14
|
|
