|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
IP
|
$614.44
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$427.65 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna Commercial |
$522.27
|
| Rate for Payer: BCBS Trust/PPO |
$507.47
|
| Rate for Payer: BCN Commercial |
$507.47
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cofinity Commercial |
$528.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.55
|
| Rate for Payer: Healthscope Commercial |
$553.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.27
|
| Rate for Payer: Nomi Health Commercial |
$503.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.83
|
| Rate for Payer: PHP Commercial |
$522.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$534.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.71
|
| Rate for Payer: UHC Core |
$513.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.83
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
OP
|
$614.44
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.33 |
| Max. Negotiated Rate |
$553.00 |
| Rate for Payer: Aetna Commercial |
$522.27
|
| Rate for Payer: Aetna Medicare |
$159.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.01
|
| Rate for Payer: BCBS Complete |
$113.73
|
| Rate for Payer: BCBS MAPPO |
$153.61
|
| Rate for Payer: BCBS Trust/PPO |
$505.13
|
| Rate for Payer: BCN Commercial |
$505.13
|
| Rate for Payer: BCN Medicare Advantage |
$153.61
|
| Rate for Payer: Cash Price |
$491.55
|
| Rate for Payer: Cofinity Commercial |
$528.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.61
|
| Rate for Payer: Healthscope Commercial |
$553.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.83
|
| Rate for Payer: Mclaren Medicaid |
$108.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.29
|
| Rate for Payer: Meridian Medicaid |
$113.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.27
|
| Rate for Payer: Nomi Health Commercial |
$503.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.83
|
| Rate for Payer: PACE Senior Care Partners |
$145.93
|
| Rate for Payer: PACE SWMI |
$153.61
|
| Rate for Payer: PHP Commercial |
$522.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$534.56
|
| Rate for Payer: Priority Health Medicare |
$155.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.65
|
| Rate for Payer: Railroad Medicare Medicare |
$153.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.71
|
| Rate for Payer: UHC Core |
$513.06
|
| Rate for Payer: UHC Exchange |
$153.61
|
| Rate for Payer: UHC Medicaid |
$108.33
|
| Rate for Payer: UHC Medicare Advantage |
$153.61
|
| Rate for Payer: UHCCP Medicaid |
$108.33
|
| Rate for Payer: VA VA |
$153.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.83
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
OP
|
$180.41
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.81 |
| Max. Negotiated Rate |
$162.37 |
| Rate for Payer: Aetna Commercial |
$153.35
|
| Rate for Payer: Aetna Medicare |
$46.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.38
|
| Rate for Payer: BCBS Complete |
$33.39
|
| Rate for Payer: BCBS MAPPO |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$148.32
|
| Rate for Payer: BCN Commercial |
$148.32
|
| Rate for Payer: BCN Medicare Advantage |
$45.10
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cofinity Commercial |
$155.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.10
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.31
|
| Rate for Payer: Mclaren Medicaid |
$31.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.36
|
| Rate for Payer: Meridian Medicaid |
$33.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.35
|
| Rate for Payer: Nomi Health Commercial |
$147.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.31
|
| Rate for Payer: PACE Senior Care Partners |
$42.85
|
| Rate for Payer: PACE SWMI |
$45.10
|
| Rate for Payer: PHP Commercial |
$153.35
|
| Rate for Payer: PHP Medicare Advantage |
$45.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$156.96
|
| Rate for Payer: Priority Health Medicare |
$45.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.57
|
| Rate for Payer: Railroad Medicare Medicare |
$45.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.76
|
| Rate for Payer: UHC Core |
$150.64
|
| Rate for Payer: UHC Exchange |
$45.10
|
| Rate for Payer: UHC Medicaid |
$31.81
|
| Rate for Payer: UHC Medicare Advantage |
$45.10
|
| Rate for Payer: UHCCP Medicaid |
$31.81
|
| Rate for Payer: VA VA |
$45.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.31
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
IP
|
$180.41
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.57 |
| Max. Negotiated Rate |
$162.37 |
| Rate for Payer: Aetna Commercial |
$153.35
|
| Rate for Payer: BCBS Trust/PPO |
$149.00
|
| Rate for Payer: BCN Commercial |
$149.00
|
| Rate for Payer: Cash Price |
$144.33
|
| Rate for Payer: Cofinity Commercial |
$155.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.33
|
| Rate for Payer: Healthscope Commercial |
$162.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.35
|
| Rate for Payer: Nomi Health Commercial |
$147.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.31
|
| Rate for Payer: PHP Commercial |
$153.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$156.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.76
|
| Rate for Payer: UHC Core |
$150.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.31
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
IP
|
$499.83
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$347.88 |
| Max. Negotiated Rate |
$449.85 |
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: BCBS Trust/PPO |
$412.81
|
| Rate for Payer: BCN Commercial |
$412.81
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$409.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$434.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.85
|
| Rate for Payer: UHC Core |
$417.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
OP
|
$499.83
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.12 |
| Max. Negotiated Rate |
$449.85 |
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: Aetna Medicare |
$129.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.20
|
| Rate for Payer: BCBS Complete |
$92.52
|
| Rate for Payer: BCBS MAPPO |
$124.96
|
| Rate for Payer: BCBS Trust/PPO |
$410.91
|
| Rate for Payer: BCN Commercial |
$410.91
|
| Rate for Payer: BCN Medicare Advantage |
$124.96
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.96
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Mclaren Medicaid |
$88.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.21
|
| Rate for Payer: Meridian Medicaid |
$92.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$409.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PACE Senior Care Partners |
$118.71
|
| Rate for Payer: PACE SWMI |
$124.96
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: PHP Medicare Advantage |
$124.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$434.85
|
| Rate for Payer: Priority Health Medicare |
$126.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.88
|
| Rate for Payer: Railroad Medicare Medicare |
$124.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.85
|
| Rate for Payer: UHC Core |
$417.36
|
| Rate for Payer: UHC Exchange |
$124.96
|
| Rate for Payer: UHC Medicaid |
$88.12
|
| Rate for Payer: UHC Medicare Advantage |
$124.96
|
| Rate for Payer: UHCCP Medicaid |
$88.12
|
| Rate for Payer: VA VA |
$124.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.88 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: BCBS Trust/PPO |
$136.32
|
| Rate for Payer: BCN Commercial |
$136.32
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.10 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: Aetna Medicare |
$42.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.58
|
| Rate for Payer: BCBS Complete |
$30.55
|
| Rate for Payer: BCBS MAPPO |
$41.27
|
| Rate for Payer: BCBS Trust/PPO |
$135.70
|
| Rate for Payer: BCN Commercial |
$135.70
|
| Rate for Payer: BCN Medicare Advantage |
$41.27
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.27
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Mclaren Medicaid |
$29.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.33
|
| Rate for Payer: Meridian Medicaid |
$30.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PACE Senior Care Partners |
$39.20
|
| Rate for Payer: PACE SWMI |
$41.27
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: PHP Medicare Advantage |
$41.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: Railroad Medicare Medicare |
$41.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: UHC Exchange |
$41.27
|
| Rate for Payer: UHC Medicaid |
$29.10
|
| Rate for Payer: UHC Medicare Advantage |
$41.27
|
| Rate for Payer: UHCCP Medicaid |
$29.10
|
| Rate for Payer: VA VA |
$41.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
OP
|
$180.06
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$162.05 |
| Rate for Payer: Aetna Commercial |
$153.05
|
| Rate for Payer: Aetna Medicare |
$46.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.27
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$45.02
|
| Rate for Payer: BCBS Trust/PPO |
$148.03
|
| Rate for Payer: BCN Commercial |
$148.03
|
| Rate for Payer: BCN Medicare Advantage |
$45.02
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cofinity Commercial |
$154.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.02
|
| Rate for Payer: Healthscope Commercial |
$162.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.04
|
| Rate for Payer: Mclaren Medicaid |
$31.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.27
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.05
|
| Rate for Payer: Nomi Health Commercial |
$147.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.04
|
| Rate for Payer: PACE Senior Care Partners |
$42.76
|
| Rate for Payer: PACE SWMI |
$45.02
|
| Rate for Payer: PHP Commercial |
$153.05
|
| Rate for Payer: PHP Medicare Advantage |
$45.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$156.65
|
| Rate for Payer: Priority Health Medicare |
$45.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.32
|
| Rate for Payer: Railroad Medicare Medicare |
$45.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.45
|
| Rate for Payer: UHC Core |
$150.35
|
| Rate for Payer: UHC Exchange |
$45.02
|
| Rate for Payer: UHC Medicaid |
$31.74
|
| Rate for Payer: UHC Medicare Advantage |
$45.02
|
| Rate for Payer: UHCCP Medicaid |
$31.74
|
| Rate for Payer: VA VA |
$45.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.04
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
IP
|
$180.06
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.32 |
| Max. Negotiated Rate |
$162.05 |
| Rate for Payer: Aetna Commercial |
$153.05
|
| Rate for Payer: BCBS Trust/PPO |
$148.71
|
| Rate for Payer: BCN Commercial |
$148.71
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cofinity Commercial |
$154.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.05
|
| Rate for Payer: Healthscope Commercial |
$162.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.05
|
| Rate for Payer: Nomi Health Commercial |
$147.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.04
|
| Rate for Payer: PHP Commercial |
$153.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$156.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.45
|
| Rate for Payer: UHC Core |
$150.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.04
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
IP
|
$1,464.47
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,019.27 |
| Max. Negotiated Rate |
$1,318.02 |
| Rate for Payer: Aetna Commercial |
$1,244.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,209.51
|
| Rate for Payer: BCN Commercial |
$1,209.51
|
| Rate for Payer: Cash Price |
$1,171.58
|
| Rate for Payer: Cofinity Commercial |
$1,259.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,171.58
|
| Rate for Payer: Healthscope Commercial |
$1,318.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,098.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.80
|
| Rate for Payer: Nomi Health Commercial |
$1,200.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.35
|
| Rate for Payer: PHP Commercial |
$1,244.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,274.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.73
|
| Rate for Payer: UHC Core |
$1,222.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,098.35
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
OP
|
$1,464.47
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$258.19 |
| Max. Negotiated Rate |
$1,318.02 |
| Rate for Payer: Aetna Commercial |
$1,244.80
|
| Rate for Payer: Aetna Medicare |
$380.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$457.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$457.65
|
| Rate for Payer: BCBS Complete |
$271.07
|
| Rate for Payer: BCBS MAPPO |
$366.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.94
|
| Rate for Payer: BCN Commercial |
$1,203.94
|
| Rate for Payer: BCN Medicare Advantage |
$366.12
|
| Rate for Payer: Cash Price |
$1,171.58
|
| Rate for Payer: Cofinity Commercial |
$1,259.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,171.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.12
|
| Rate for Payer: Healthscope Commercial |
$1,318.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,098.35
|
| Rate for Payer: Mclaren Medicaid |
$258.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$384.42
|
| Rate for Payer: Meridian Medicaid |
$271.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$402.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,244.80
|
| Rate for Payer: Nomi Health Commercial |
$1,200.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,098.35
|
| Rate for Payer: PACE Senior Care Partners |
$347.81
|
| Rate for Payer: PACE SWMI |
$366.12
|
| Rate for Payer: PHP Commercial |
$1,244.80
|
| Rate for Payer: PHP Medicare Advantage |
$366.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,274.09
|
| Rate for Payer: Priority Health Medicare |
$369.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.27
|
| Rate for Payer: Railroad Medicare Medicare |
$366.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,288.73
|
| Rate for Payer: UHC Core |
$1,222.83
|
| Rate for Payer: UHC Exchange |
$366.12
|
| Rate for Payer: UHC Medicaid |
$258.19
|
| Rate for Payer: UHC Medicare Advantage |
$366.12
|
| Rate for Payer: UHCCP Medicaid |
$258.19
|
| Rate for Payer: VA VA |
$366.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,098.35
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
OP
|
$2,736.85
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.51 |
| Max. Negotiated Rate |
$2,463.16 |
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: Aetna Medicare |
$711.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$855.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$855.27
|
| Rate for Payer: BCBS Complete |
$506.59
|
| Rate for Payer: BCBS MAPPO |
$684.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.96
|
| Rate for Payer: BCN Commercial |
$2,249.96
|
| Rate for Payer: BCN Medicare Advantage |
$684.21
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.21
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.64
|
| Rate for Payer: Mclaren Medicaid |
$482.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.42
|
| Rate for Payer: Meridian Medicaid |
$506.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Nomi Health Commercial |
$2,244.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PACE Senior Care Partners |
$650.00
|
| Rate for Payer: PACE SWMI |
$684.21
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: PHP Medicare Advantage |
$684.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.06
|
| Rate for Payer: Priority Health Medicare |
$691.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.85
|
| Rate for Payer: Railroad Medicare Medicare |
$684.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.43
|
| Rate for Payer: UHC Core |
$2,285.27
|
| Rate for Payer: UHC Exchange |
$684.21
|
| Rate for Payer: UHC Medicaid |
$482.51
|
| Rate for Payer: UHC Medicare Advantage |
$684.21
|
| Rate for Payer: UHCCP Medicaid |
$482.51
|
| Rate for Payer: VA VA |
$684.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.64
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
IP
|
$2,736.85
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,904.85 |
| Max. Negotiated Rate |
$2,463.16 |
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,260.36
|
| Rate for Payer: BCN Commercial |
$2,260.36
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Nomi Health Commercial |
$2,244.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.43
|
| Rate for Payer: UHC Core |
$2,285.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.64
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
OP
|
$2,583.10
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,324.79 |
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: Aetna Medicare |
$671.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$807.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$807.22
|
| Rate for Payer: BCBS Complete |
$478.13
|
| Rate for Payer: BCBS MAPPO |
$645.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,123.57
|
| Rate for Payer: BCN Commercial |
$2,123.57
|
| Rate for Payer: BCN Medicare Advantage |
$645.77
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.77
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Mclaren Medicaid |
$455.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.06
|
| Rate for Payer: Meridian Medicaid |
$478.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$742.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$710.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PACE Senior Care Partners |
$613.49
|
| Rate for Payer: PACE SWMI |
$645.77
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: PHP Medicare Advantage |
$645.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,247.30
|
| Rate for Payer: Priority Health Medicare |
$652.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.84
|
| Rate for Payer: Railroad Medicare Medicare |
$645.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.13
|
| Rate for Payer: UHC Core |
$2,156.89
|
| Rate for Payer: UHC Exchange |
$645.77
|
| Rate for Payer: UHC Medicaid |
$455.40
|
| Rate for Payer: UHC Medicare Advantage |
$645.77
|
| Rate for Payer: UHCCP Medicaid |
$455.40
|
| Rate for Payer: VA VA |
$645.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,583.10
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,797.84 |
| Max. Negotiated Rate |
$2,324.79 |
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,133.38
|
| Rate for Payer: BCN Commercial |
$2,133.38
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,247.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.13
|
| Rate for Payer: UHC Core |
$2,156.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,583.10
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,324.79 |
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: Aetna Medicare |
$671.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$807.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$807.22
|
| Rate for Payer: BCBS Complete |
$478.13
|
| Rate for Payer: BCBS MAPPO |
$645.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,123.57
|
| Rate for Payer: BCN Commercial |
$2,123.57
|
| Rate for Payer: BCN Medicare Advantage |
$645.77
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.77
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Mclaren Medicaid |
$455.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.06
|
| Rate for Payer: Meridian Medicaid |
$478.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$742.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$710.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PACE Senior Care Partners |
$613.49
|
| Rate for Payer: PACE SWMI |
$645.77
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: PHP Medicare Advantage |
$645.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,247.30
|
| Rate for Payer: Priority Health Medicare |
$652.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.84
|
| Rate for Payer: Railroad Medicare Medicare |
$645.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.13
|
| Rate for Payer: UHC Core |
$2,156.89
|
| Rate for Payer: UHC Exchange |
$645.77
|
| Rate for Payer: UHC Medicaid |
$455.40
|
| Rate for Payer: UHC Medicare Advantage |
$645.77
|
| Rate for Payer: UHCCP Medicaid |
$455.40
|
| Rate for Payer: VA VA |
$645.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,583.10
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,797.84 |
| Max. Negotiated Rate |
$2,324.79 |
| Rate for Payer: Aetna Commercial |
$2,195.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,133.38
|
| Rate for Payer: BCN Commercial |
$2,133.38
|
| Rate for Payer: Cash Price |
$2,066.48
|
| Rate for Payer: Cofinity Commercial |
$2,221.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,066.48
|
| Rate for Payer: Healthscope Commercial |
$2,324.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,937.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,195.64
|
| Rate for Payer: Nomi Health Commercial |
$2,118.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,937.33
|
| Rate for Payer: PHP Commercial |
$2,195.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,247.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,273.13
|
| Rate for Payer: UHC Core |
$2,156.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,937.33
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$400.07
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$278.45 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: BCBS Trust/PPO |
$330.42
|
| Rate for Payer: BCN Commercial |
$330.42
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Nomi Health Commercial |
$328.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$348.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.06
|
| Rate for Payer: UHC Core |
$334.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$400.07
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.53 |
| Max. Negotiated Rate |
$360.06 |
| Rate for Payer: Aetna Commercial |
$340.06
|
| Rate for Payer: Aetna Medicare |
$104.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.02
|
| Rate for Payer: BCBS Complete |
$74.05
|
| Rate for Payer: BCBS MAPPO |
$100.02
|
| Rate for Payer: BCBS Trust/PPO |
$328.90
|
| Rate for Payer: BCN Commercial |
$328.90
|
| Rate for Payer: BCN Medicare Advantage |
$100.02
|
| Rate for Payer: Cash Price |
$320.06
|
| Rate for Payer: Cofinity Commercial |
$344.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.02
|
| Rate for Payer: Healthscope Commercial |
$360.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.05
|
| Rate for Payer: Mclaren Medicaid |
$70.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.02
|
| Rate for Payer: Meridian Medicaid |
$74.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$340.06
|
| Rate for Payer: Nomi Health Commercial |
$328.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$300.05
|
| Rate for Payer: PACE Senior Care Partners |
$95.02
|
| Rate for Payer: PACE SWMI |
$100.02
|
| Rate for Payer: PHP Commercial |
$340.06
|
| Rate for Payer: PHP Medicare Advantage |
$100.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$348.06
|
| Rate for Payer: Priority Health Medicare |
$101.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$278.45
|
| Rate for Payer: Railroad Medicare Medicare |
$100.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.06
|
| Rate for Payer: UHC Core |
$334.06
|
| Rate for Payer: UHC Exchange |
$100.02
|
| Rate for Payer: UHC Medicaid |
$70.53
|
| Rate for Payer: UHC Medicare Advantage |
$100.02
|
| Rate for Payer: UHCCP Medicaid |
$70.53
|
| Rate for Payer: VA VA |
$100.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.05
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$223.91
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.48 |
| Max. Negotiated Rate |
$201.52 |
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: Aetna Medicare |
$58.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.97
|
| Rate for Payer: BCBS Complete |
$41.45
|
| Rate for Payer: BCBS MAPPO |
$55.98
|
| Rate for Payer: BCBS Trust/PPO |
$184.08
|
| Rate for Payer: BCN Commercial |
$184.08
|
| Rate for Payer: BCN Medicare Advantage |
$55.98
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.98
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Mclaren Medicaid |
$39.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.78
|
| Rate for Payer: Meridian Medicaid |
$41.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PACE Senior Care Partners |
$53.18
|
| Rate for Payer: PACE SWMI |
$55.98
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: PHP Medicare Advantage |
$55.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.80
|
| Rate for Payer: Priority Health Medicare |
$56.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.84
|
| Rate for Payer: Railroad Medicare Medicare |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.04
|
| Rate for Payer: UHC Core |
$186.96
|
| Rate for Payer: UHC Exchange |
$55.98
|
| Rate for Payer: UHC Medicaid |
$39.48
|
| Rate for Payer: UHC Medicare Advantage |
$55.98
|
| Rate for Payer: UHCCP Medicaid |
$39.48
|
| Rate for Payer: VA VA |
$55.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$223.91
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.84 |
| Max. Negotiated Rate |
$201.52 |
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: BCBS Trust/PPO |
$184.93
|
| Rate for Payer: BCN Commercial |
$184.93
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.04
|
| Rate for Payer: UHC Core |
$186.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.91 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$237.21
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.88 |
| Max. Negotiated Rate |
$148.55 |
| Rate for Payer: Aetna Commercial |
$140.30
|
| Rate for Payer: BCBS Trust/PPO |
$136.32
|
| Rate for Payer: BCN Commercial |
$136.32
|
| Rate for Payer: Cash Price |
$132.05
|
| Rate for Payer: Cofinity Commercial |
$141.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.05
|
| Rate for Payer: Healthscope Commercial |
$148.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.30
|
| Rate for Payer: Nomi Health Commercial |
$135.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.80
|
| Rate for Payer: PHP Commercial |
$140.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.25
|
| Rate for Payer: UHC Core |
$137.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.80
|
|
