|
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
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.90 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: BCBS Trust/PPO |
$260.94
|
| Rate for Payer: BCN Commercial |
$260.94
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.04
|
| Rate for Payer: UHC Core |
$263.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.70 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna Medicare |
$82.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.73
|
| Rate for Payer: BCBS Complete |
$58.48
|
| Rate for Payer: BCBS MAPPO |
$78.99
|
| Rate for Payer: BCBS Trust/PPO |
$259.74
|
| Rate for Payer: BCN Commercial |
$259.74
|
| Rate for Payer: BCN Medicare Advantage |
$78.99
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.99
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Mclaren Medicaid |
$55.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.94
|
| Rate for Payer: Meridian Medicaid |
$58.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Senior Care Partners |
$75.04
|
| Rate for Payer: PACE SWMI |
$78.99
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: PHP Medicare Advantage |
$78.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.88
|
| Rate for Payer: Priority Health Medicare |
$79.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.90
|
| Rate for Payer: Railroad Medicare Medicare |
$78.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.04
|
| Rate for Payer: UHC Core |
$263.82
|
| Rate for Payer: UHC Exchange |
$78.99
|
| Rate for Payer: UHC Medicaid |
$55.70
|
| Rate for Payer: UHC Medicare Advantage |
$78.99
|
| Rate for Payer: UHCCP Medicaid |
$55.70
|
| Rate for Payer: VA VA |
$78.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$165.06
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$165.06
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$543.09
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$377.99 |
| Max. Negotiated Rate |
$488.78 |
| Rate for Payer: Aetna Commercial |
$461.63
|
| Rate for Payer: BCBS Trust/PPO |
$448.54
|
| Rate for Payer: BCN Commercial |
$448.54
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cofinity Commercial |
$467.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.47
|
| Rate for Payer: Healthscope Commercial |
$488.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.63
|
| Rate for Payer: Nomi Health Commercial |
$445.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.32
|
| Rate for Payer: PHP Commercial |
$461.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$472.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.92
|
| Rate for Payer: UHC Core |
$453.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.32
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$543.09
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.75 |
| Max. Negotiated Rate |
$488.78 |
| Rate for Payer: Aetna Commercial |
$461.63
|
| Rate for Payer: Aetna Medicare |
$141.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.72
|
| Rate for Payer: BCBS Complete |
$100.53
|
| Rate for Payer: BCBS MAPPO |
$135.77
|
| Rate for Payer: BCBS Trust/PPO |
$446.47
|
| Rate for Payer: BCN Commercial |
$446.47
|
| Rate for Payer: BCN Medicare Advantage |
$135.77
|
| Rate for Payer: Cash Price |
$434.47
|
| Rate for Payer: Cofinity Commercial |
$467.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.77
|
| Rate for Payer: Healthscope Commercial |
$488.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.32
|
| Rate for Payer: Mclaren Medicaid |
$95.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.56
|
| Rate for Payer: Meridian Medicaid |
$100.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.63
|
| Rate for Payer: Nomi Health Commercial |
$445.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.32
|
| Rate for Payer: PACE Senior Care Partners |
$128.98
|
| Rate for Payer: PACE SWMI |
$135.77
|
| Rate for Payer: PHP Commercial |
$461.63
|
| Rate for Payer: PHP Medicare Advantage |
$135.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$472.49
|
| Rate for Payer: Priority Health Medicare |
$137.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.99
|
| Rate for Payer: Railroad Medicare Medicare |
$135.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.92
|
| Rate for Payer: UHC Core |
$453.48
|
| Rate for Payer: UHC Exchange |
$135.77
|
| Rate for Payer: UHC Medicaid |
$95.75
|
| Rate for Payer: UHC Medicare Advantage |
$135.77
|
| Rate for Payer: UHCCP Medicaid |
$95.75
|
| Rate for Payer: VA VA |
$135.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.32
|
|
|
HC DESTRUCT MOUTH LESION
|
Facility
|
IP
|
$9,995.00
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
76100538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,956.52 |
| Max. Negotiated Rate |
$8,995.50 |
| Rate for Payer: Aetna Commercial |
$8,495.75
|
| Rate for Payer: BCBS Trust/PPO |
$8,254.87
|
| Rate for Payer: BCN Commercial |
$8,254.87
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Commercial |
$8,595.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Healthscope Commercial |
$8,995.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,496.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$8,195.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: PHP Commercial |
$8,495.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,695.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,956.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,795.60
|
| Rate for Payer: UHC Core |
$8,345.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,496.25
|
|
|
HC DESTRUCT MOUTH LESION
|
Facility
|
OP
|
$9,995.00
|
|
|
Service Code
|
CPT 40820
|
| Hospital Charge Code |
76100538
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,762.12 |
| Max. Negotiated Rate |
$8,995.50 |
| Rate for Payer: Aetna Commercial |
$8,495.75
|
| Rate for Payer: Aetna Medicare |
$2,598.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,123.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,123.44
|
| Rate for Payer: BCBS Complete |
$1,850.07
|
| Rate for Payer: BCBS MAPPO |
$2,498.75
|
| Rate for Payer: BCBS Trust/PPO |
$8,216.89
|
| Rate for Payer: BCN Commercial |
$8,216.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,498.75
|
| Rate for Payer: Cash Price |
$7,996.00
|
| Rate for Payer: Cofinity Commercial |
$8,595.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,996.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,498.75
|
| Rate for Payer: Healthscope Commercial |
$8,995.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,496.25
|
| Rate for Payer: Mclaren Medicaid |
$1,762.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,623.69
|
| Rate for Payer: Meridian Medicaid |
$1,850.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,873.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,495.75
|
| Rate for Payer: Nomi Health Commercial |
$8,195.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,496.25
|
| Rate for Payer: PACE Senior Care Partners |
$2,373.81
|
| Rate for Payer: PACE SWMI |
$2,498.75
|
| Rate for Payer: PHP Commercial |
$8,495.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,498.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,762.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,695.65
|
| Rate for Payer: Priority Health Medicare |
$2,523.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,956.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,498.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,795.60
|
| Rate for Payer: UHC Core |
$8,345.83
|
| Rate for Payer: UHC Exchange |
$2,498.75
|
| Rate for Payer: UHC Medicaid |
$1,762.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,498.75
|
| Rate for Payer: UHCCP Medicaid |
$1,762.12
|
| Rate for Payer: VA VA |
$2,498.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,496.25
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
IP
|
$417.06
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$290.27 |
| Max. Negotiated Rate |
$375.35 |
| Rate for Payer: Aetna Commercial |
$354.50
|
| Rate for Payer: BCBS Trust/PPO |
$344.45
|
| Rate for Payer: BCN Commercial |
$344.45
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cofinity Commercial |
$358.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.65
|
| Rate for Payer: Healthscope Commercial |
$375.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.50
|
| Rate for Payer: Nomi Health Commercial |
$341.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.80
|
| Rate for Payer: PHP Commercial |
$354.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.01
|
| Rate for Payer: UHC Core |
$348.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.80
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
OP
|
$417.06
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.53 |
| Max. Negotiated Rate |
$375.35 |
| Rate for Payer: Aetna Commercial |
$354.50
|
| Rate for Payer: Aetna Medicare |
$108.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.33
|
| Rate for Payer: BCBS Complete |
$77.20
|
| Rate for Payer: BCBS MAPPO |
$104.27
|
| Rate for Payer: BCBS Trust/PPO |
$342.87
|
| Rate for Payer: BCN Commercial |
$342.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.27
|
| Rate for Payer: Cash Price |
$333.65
|
| Rate for Payer: Cofinity Commercial |
$358.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.27
|
| Rate for Payer: Healthscope Commercial |
$375.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.80
|
| Rate for Payer: Mclaren Medicaid |
$73.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.48
|
| Rate for Payer: Meridian Medicaid |
$77.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.50
|
| Rate for Payer: Nomi Health Commercial |
$341.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.80
|
| Rate for Payer: PACE Senior Care Partners |
$99.05
|
| Rate for Payer: PACE SWMI |
$104.27
|
| Rate for Payer: PHP Commercial |
$354.50
|
| Rate for Payer: PHP Medicare Advantage |
$104.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.84
|
| Rate for Payer: Priority Health Medicare |
$105.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.27
|
| Rate for Payer: Railroad Medicare Medicare |
$104.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.01
|
| Rate for Payer: UHC Core |
$348.25
|
| Rate for Payer: UHC Exchange |
$104.27
|
| Rate for Payer: UHC Medicaid |
$73.53
|
| Rate for Payer: UHC Medicare Advantage |
$104.27
|
| Rate for Payer: UHCCP Medicaid |
$73.53
|
| Rate for Payer: VA VA |
$104.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.80
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
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 PREMALIGNANT LESIONS 15 OR MORE LESIONS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 17004
|
| Hospital Charge Code |
76100122
|
|
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 PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
IP
|
$180.06
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
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 PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
OP
|
$180.06
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
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 PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
OP
|
$36.19
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$32.57 |
| Rate for Payer: Aetna Commercial |
$30.76
|
| Rate for Payer: Aetna Medicare |
$9.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.31
|
| Rate for Payer: BCBS Complete |
$6.70
|
| Rate for Payer: BCBS MAPPO |
$9.05
|
| Rate for Payer: BCBS Trust/PPO |
$29.75
|
| Rate for Payer: BCN Commercial |
$29.75
|
| Rate for Payer: BCN Medicare Advantage |
$9.05
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cofinity Commercial |
$31.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.05
|
| Rate for Payer: Healthscope Commercial |
$32.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.14
|
| Rate for Payer: Mclaren Medicaid |
$6.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$6.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.76
|
| Rate for Payer: Nomi Health Commercial |
$29.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.14
|
| Rate for Payer: PACE Senior Care Partners |
$8.60
|
| Rate for Payer: PACE SWMI |
$9.05
|
| Rate for Payer: PHP Commercial |
$30.76
|
| Rate for Payer: PHP Medicare Advantage |
$9.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.49
|
| Rate for Payer: Priority Health Medicare |
$9.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.19
|
| Rate for Payer: Railroad Medicare Medicare |
$9.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.85
|
| Rate for Payer: UHC Core |
$30.22
|
| Rate for Payer: UHC Exchange |
$9.05
|
| Rate for Payer: UHC Medicaid |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$9.05
|
| Rate for Payer: UHCCP Medicaid |
$6.38
|
| Rate for Payer: VA VA |
$9.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.14
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
IP
|
$36.19
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.19 |
| Max. Negotiated Rate |
$32.57 |
| Rate for Payer: Aetna Commercial |
$30.76
|
| Rate for Payer: BCBS Trust/PPO |
$29.89
|
| Rate for Payer: BCN Commercial |
$29.89
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cofinity Commercial |
$31.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.95
|
| Rate for Payer: Healthscope Commercial |
$32.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.76
|
| Rate for Payer: Nomi Health Commercial |
$29.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.14
|
| Rate for Payer: PHP Commercial |
$30.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.85
|
| Rate for Payer: UHC Core |
$30.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.14
|
|
|
HC DESTRUCT VAGINAL LESION(S) SIMPLE
|
Facility
|
IP
|
$3,976.50
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
36100583
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,767.64 |
| Max. Negotiated Rate |
$3,578.85 |
| Rate for Payer: Aetna Commercial |
$3,380.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,284.19
|
| Rate for Payer: BCN Commercial |
$3,284.19
|
| Rate for Payer: Cash Price |
$3,181.20
|
| Rate for Payer: Cofinity Commercial |
$3,419.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,181.20
|
| Rate for Payer: Healthscope Commercial |
$3,578.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,982.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,380.03
|
| Rate for Payer: Nomi Health Commercial |
$3,260.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,982.38
|
| Rate for Payer: PHP Commercial |
$3,380.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,459.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,767.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,499.32
|
| Rate for Payer: UHC Core |
$3,320.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,982.38
|
|
|
HC DESTRUCT VAGINAL LESION(S) SIMPLE
|
Facility
|
OP
|
$3,976.50
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
36100583
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$701.06 |
| Max. Negotiated Rate |
$3,578.85 |
| Rate for Payer: Aetna Commercial |
$3,380.03
|
| Rate for Payer: Aetna Medicare |
$1,033.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,242.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,242.66
|
| Rate for Payer: BCBS Complete |
$736.05
|
| Rate for Payer: BCBS MAPPO |
$994.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,269.08
|
| Rate for Payer: BCN Commercial |
$3,269.08
|
| Rate for Payer: BCN Medicare Advantage |
$994.12
|
| Rate for Payer: Cash Price |
$3,181.20
|
| Rate for Payer: Cofinity Commercial |
$3,419.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,181.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$994.12
|
| Rate for Payer: Healthscope Commercial |
$3,578.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,982.38
|
| Rate for Payer: Mclaren Medicaid |
$701.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,043.83
|
| Rate for Payer: Meridian Medicaid |
$736.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,143.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,093.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,380.03
|
| Rate for Payer: Nomi Health Commercial |
$3,260.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,982.38
|
| Rate for Payer: PACE Senior Care Partners |
$944.42
|
| Rate for Payer: PACE SWMI |
$994.12
|
| Rate for Payer: PHP Commercial |
$3,380.03
|
| Rate for Payer: PHP Medicare Advantage |
$994.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$701.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,459.55
|
| Rate for Payer: Priority Health Medicare |
$1,004.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,767.64
|
| Rate for Payer: Railroad Medicare Medicare |
$994.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,499.32
|
| Rate for Payer: UHC Core |
$3,320.38
|
| Rate for Payer: UHC Exchange |
$994.12
|
| Rate for Payer: UHC Medicaid |
$701.06
|
| Rate for Payer: UHC Medicare Advantage |
$994.12
|
| Rate for Payer: UHCCP Medicaid |
$701.06
|
| Rate for Payer: VA VA |
$994.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,982.38
|
|
|
HC DES VESSEL/BRANCH
|
Facility
|
IP
|
$25,160.93
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
48100075
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,512.01 |
| Max. Negotiated Rate |
$22,644.84 |
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: BCBS Trust/PPO |
$20,780.41
|
| Rate for Payer: BCN Commercial |
$20,780.41
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,870.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$20,631.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21,890.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,512.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,141.62
|
| Rate for Payer: UHC Core |
$21,009.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,870.70
|
|
|
HC DES VESSEL/BRANCH
|
Facility
|
OP
|
$25,160.93
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
48100075
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,435.87 |
| Max. Negotiated Rate |
$22,644.84 |
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna Medicare |
$6,541.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,862.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,862.79
|
| Rate for Payer: BCBS Complete |
$4,657.29
|
| Rate for Payer: BCBS MAPPO |
$6,290.23
|
| Rate for Payer: BCBS Trust/PPO |
$20,684.80
|
| Rate for Payer: BCN Commercial |
$20,684.80
|
| Rate for Payer: BCN Medicare Advantage |
$6,290.23
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,290.23
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,870.70
|
| Rate for Payer: Mclaren Medicaid |
$4,435.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,604.74
|
| Rate for Payer: Meridian Medicaid |
$4,657.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,233.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,919.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$20,631.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PACE Senior Care Partners |
$5,975.72
|
| Rate for Payer: PACE SWMI |
$6,290.23
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: PHP Medicare Advantage |
$6,290.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,435.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21,890.01
|
| Rate for Payer: Priority Health Medicare |
$6,353.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,512.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6,290.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,141.62
|
| Rate for Payer: UHC Core |
$21,009.38
|
| Rate for Payer: UHC Exchange |
$6,290.23
|
| Rate for Payer: UHC Medicaid |
$4,435.87
|
| Rate for Payer: UHC Medicare Advantage |
$6,290.23
|
| Rate for Payer: UHCCP Medicaid |
$4,435.87
|
| Rate for Payer: VA VA |
$6,290.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,870.70
|
|
