|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.01 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: BCBS Trust/PPO |
$505.52
|
| Rate for Payer: BCN Commercial |
$505.52
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 0.6 CM TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
76100090
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$159.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.28
|
| Rate for Payer: BCBS Complete |
$113.30
|
| Rate for Payer: BCBS MAPPO |
$153.02
|
| Rate for Payer: BCBS Trust/PPO |
$503.19
|
| Rate for Payer: BCN Commercial |
$503.19
|
| Rate for Payer: BCN Medicare Advantage |
$153.02
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.02
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$107.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.67
|
| Rate for Payer: Meridian Medicaid |
$113.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Senior Care Partners |
$145.37
|
| Rate for Payer: PACE SWMI |
$153.02
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Medicare |
$154.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: Railroad Medicare Medicare |
$153.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: UHC Exchange |
$153.02
|
| Rate for Payer: UHC Medicaid |
$107.91
|
| Rate for Payer: UHC Medicare Advantage |
$153.02
|
| Rate for Payer: UHCCP Medicaid |
$107.91
|
| Rate for Payer: VA VA |
$153.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
OP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.74 |
| Max. Negotiated Rate |
$1,188.13 |
| Rate for Payer: Aetna Commercial |
$1,122.13
|
| Rate for Payer: Aetna Medicare |
$343.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$412.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$412.55
|
| Rate for Payer: BCBS Complete |
$244.36
|
| Rate for Payer: BCBS MAPPO |
$330.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.30
|
| Rate for Payer: BCN Commercial |
$1,085.30
|
| Rate for Payer: BCN Medicare Advantage |
$330.04
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Commercial |
$1,135.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.04
|
| Rate for Payer: Healthscope Commercial |
$1,188.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.11
|
| Rate for Payer: Mclaren Medicaid |
$232.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$346.54
|
| Rate for Payer: Meridian Medicaid |
$244.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$379.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$363.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Nomi Health Commercial |
$1,082.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PACE Senior Care Partners |
$313.54
|
| Rate for Payer: PACE SWMI |
$330.04
|
| Rate for Payer: PHP Commercial |
$1,122.13
|
| Rate for Payer: PHP Medicare Advantage |
$330.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,148.53
|
| Rate for Payer: Priority Health Medicare |
$333.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$918.82
|
| Rate for Payer: Railroad Medicare Medicare |
$330.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,161.73
|
| Rate for Payer: UHC Core |
$1,102.33
|
| Rate for Payer: UHC Exchange |
$330.04
|
| Rate for Payer: UHC Medicaid |
$232.74
|
| Rate for Payer: UHC Medicare Advantage |
$330.04
|
| Rate for Payer: UHCCP Medicaid |
$232.74
|
| Rate for Payer: VA VA |
$330.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.11
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 1.1 CM TO 2.0 CM
|
Facility
|
IP
|
$1,320.15
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
76100091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$918.82 |
| Max. Negotiated Rate |
$1,188.13 |
| Rate for Payer: Aetna Commercial |
$1,122.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.31
|
| Rate for Payer: BCN Commercial |
$1,090.31
|
| Rate for Payer: Cash Price |
$1,056.12
|
| Rate for Payer: Cofinity Commercial |
$1,135.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,056.12
|
| Rate for Payer: Healthscope Commercial |
$1,188.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$990.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,122.13
|
| Rate for Payer: Nomi Health Commercial |
$1,082.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$990.11
|
| Rate for Payer: PHP Commercial |
$1,122.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,148.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$918.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,161.73
|
| Rate for Payer: UHC Core |
$1,102.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$990.11
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$311.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.87
|
| Rate for Payer: BCBS Complete |
$222.04
|
| Rate for Payer: BCBS MAPPO |
$299.89
|
| Rate for Payer: BCBS Trust/PPO |
$986.17
|
| Rate for Payer: BCN Commercial |
$986.17
|
| Rate for Payer: BCN Medicare Advantage |
$299.89
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.89
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Mclaren Medicaid |
$211.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.89
|
| Rate for Payer: Meridian Medicaid |
$222.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Senior Care Partners |
$284.90
|
| Rate for Payer: PACE SWMI |
$299.89
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$299.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Medicare |
$302.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: Railroad Medicare Medicare |
$299.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: UHC Exchange |
$299.89
|
| Rate for Payer: UHC Medicaid |
$211.48
|
| Rate for Payer: UHC Medicare Advantage |
$299.89
|
| Rate for Payer: UHCCP Medicaid |
$211.48
|
| Rate for Payer: VA VA |
$299.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
76100092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$834.90 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: BCBS Trust/PPO |
$990.72
|
| Rate for Payer: BCN Commercial |
$990.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
IP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,001.89 |
| Max. Negotiated Rate |
$1,295.54 |
| Rate for Payer: Aetna Commercial |
$1,223.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.87
|
| Rate for Payer: BCN Commercial |
$1,188.87
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Commercial |
$1,237.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Healthscope Commercial |
$1,295.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,079.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Nomi Health Commercial |
$1,180.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PHP Commercial |
$1,223.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,252.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,001.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,266.75
|
| Rate for Payer: UHC Core |
$1,201.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,079.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS 3.1 TO 4.0 CM
|
Facility
|
OP
|
$1,439.49
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
76100093
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.78 |
| Max. Negotiated Rate |
$1,295.54 |
| Rate for Payer: Aetna Commercial |
$1,223.57
|
| Rate for Payer: Aetna Medicare |
$374.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.84
|
| Rate for Payer: BCBS Complete |
$266.45
|
| Rate for Payer: BCBS MAPPO |
$359.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.40
|
| Rate for Payer: BCN Commercial |
$1,183.40
|
| Rate for Payer: BCN Medicare Advantage |
$359.87
|
| Rate for Payer: Cash Price |
$1,151.59
|
| Rate for Payer: Cofinity Commercial |
$1,237.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,151.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.87
|
| Rate for Payer: Healthscope Commercial |
$1,295.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,079.62
|
| Rate for Payer: Mclaren Medicaid |
$253.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.87
|
| Rate for Payer: Meridian Medicaid |
$266.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,223.57
|
| Rate for Payer: Nomi Health Commercial |
$1,180.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,079.62
|
| Rate for Payer: PACE Senior Care Partners |
$341.88
|
| Rate for Payer: PACE SWMI |
$359.87
|
| Rate for Payer: PHP Commercial |
$1,223.57
|
| Rate for Payer: PHP Medicare Advantage |
$359.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,252.36
|
| Rate for Payer: Priority Health Medicare |
$363.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,001.89
|
| Rate for Payer: Railroad Medicare Medicare |
$359.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,266.75
|
| Rate for Payer: UHC Core |
$1,201.97
|
| Rate for Payer: UHC Exchange |
$359.87
|
| Rate for Payer: UHC Medicaid |
$253.78
|
| Rate for Payer: UHC Medicare Advantage |
$359.87
|
| Rate for Payer: UHCCP Medicaid |
$253.78
|
| Rate for Payer: VA VA |
$359.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,079.62
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
IP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,504.22 |
| Max. Negotiated Rate |
$1,945.11 |
| Rate for Payer: Aetna Commercial |
$1,837.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,784.96
|
| Rate for Payer: BCN Commercial |
$1,784.96
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Commercial |
$1,858.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Healthscope Commercial |
$1,945.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,620.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Nomi Health Commercial |
$1,772.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PHP Commercial |
$1,837.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,880.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,504.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.88
|
| Rate for Payer: UHC Core |
$1,804.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,620.92
|
|
|
HC EXCISE BENIGN LESION TRUNK, ARMS, LEGS OVER 4.0 CM
|
Facility
|
OP
|
$2,161.23
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
76100094
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$381.02 |
| Max. Negotiated Rate |
$1,945.11 |
| Rate for Payer: Aetna Commercial |
$1,837.05
|
| Rate for Payer: Aetna Medicare |
$561.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$675.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$675.38
|
| Rate for Payer: BCBS Complete |
$400.04
|
| Rate for Payer: BCBS MAPPO |
$540.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,776.75
|
| Rate for Payer: BCN Commercial |
$1,776.75
|
| Rate for Payer: BCN Medicare Advantage |
$540.31
|
| Rate for Payer: Cash Price |
$1,728.98
|
| Rate for Payer: Cofinity Commercial |
$1,858.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.31
|
| Rate for Payer: Healthscope Commercial |
$1,945.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,620.92
|
| Rate for Payer: Mclaren Medicaid |
$381.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.32
|
| Rate for Payer: Meridian Medicaid |
$400.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$621.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$594.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,837.05
|
| Rate for Payer: Nomi Health Commercial |
$1,772.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,620.92
|
| Rate for Payer: PACE Senior Care Partners |
$513.29
|
| Rate for Payer: PACE SWMI |
$540.31
|
| Rate for Payer: PHP Commercial |
$1,837.05
|
| Rate for Payer: PHP Medicare Advantage |
$540.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,880.27
|
| Rate for Payer: Priority Health Medicare |
$545.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,504.22
|
| Rate for Payer: Railroad Medicare Medicare |
$540.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.88
|
| Rate for Payer: UHC Core |
$1,804.63
|
| Rate for Payer: UHC Exchange |
$540.31
|
| Rate for Payer: UHC Medicaid |
$381.02
|
| Rate for Payer: UHC Medicare Advantage |
$540.31
|
| Rate for Payer: UHCCP Medicaid |
$381.02
|
| Rate for Payer: VA VA |
$540.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,620.92
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
IP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,356.45 |
| Max. Negotiated Rate |
$4,340.23 |
| Rate for Payer: Aetna Commercial |
$4,099.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,982.89
|
| Rate for Payer: BCN Commercial |
$3,982.89
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Commercial |
$4,147.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Healthscope Commercial |
$4,340.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,616.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Nomi Health Commercial |
$3,954.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PHP Commercial |
$4,099.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,195.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,356.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,243.78
|
| Rate for Payer: UHC Core |
$4,026.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,616.86
|
|
|
HC EXCISE CYST/BREAST LESION
|
Facility
|
OP
|
$4,822.48
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
76100230
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$515.37 |
| Max. Negotiated Rate |
$4,340.23 |
| Rate for Payer: Aetna Commercial |
$4,099.11
|
| Rate for Payer: Aetna Medicare |
$1,253.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,507.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,507.03
|
| Rate for Payer: BCBS Complete |
$892.64
|
| Rate for Payer: BCBS MAPPO |
$1,205.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,964.56
|
| Rate for Payer: BCCCP Commercial |
$515.37
|
| Rate for Payer: BCN Commercial |
$3,964.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,205.62
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cash Price |
$3,857.98
|
| Rate for Payer: Cofinity Commercial |
$4,147.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,857.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,205.62
|
| Rate for Payer: Healthscope Commercial |
$4,340.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,616.86
|
| Rate for Payer: Mclaren Medicaid |
$850.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,265.90
|
| Rate for Payer: Meridian Medicaid |
$892.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,386.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,326.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,099.11
|
| Rate for Payer: Nomi Health Commercial |
$3,954.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,616.86
|
| Rate for Payer: PACE Senior Care Partners |
$1,145.34
|
| Rate for Payer: PACE SWMI |
$1,205.62
|
| Rate for Payer: PHP Commercial |
$4,099.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,205.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,195.56
|
| Rate for Payer: Priority Health Medicare |
$1,217.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,356.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,205.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,243.78
|
| Rate for Payer: UHC Core |
$4,026.77
|
| Rate for Payer: UHC Exchange |
$1,205.62
|
| Rate for Payer: UHC Medicaid |
$850.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,205.62
|
| Rate for Payer: UHCCP Medicaid |
$850.20
|
| Rate for Payer: VA VA |
$1,205.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,616.86
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
OP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.42 |
| Max. Negotiated Rate |
$798.51 |
| Rate for Payer: Aetna Commercial |
$754.15
|
| Rate for Payer: Aetna Medicare |
$230.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$277.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$277.26
|
| Rate for Payer: BCBS Complete |
$164.23
|
| Rate for Payer: BCBS MAPPO |
$221.81
|
| Rate for Payer: BCBS Trust/PPO |
$729.39
|
| Rate for Payer: BCN Commercial |
$729.39
|
| Rate for Payer: BCN Medicare Advantage |
$221.81
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Commercial |
$763.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.81
|
| Rate for Payer: Healthscope Commercial |
$798.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.42
|
| Rate for Payer: Mclaren Medicaid |
$156.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.90
|
| Rate for Payer: Meridian Medicaid |
$164.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$255.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$243.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Nomi Health Commercial |
$727.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PACE Senior Care Partners |
$210.72
|
| Rate for Payer: PACE SWMI |
$221.81
|
| Rate for Payer: PHP Commercial |
$754.15
|
| Rate for Payer: PHP Medicare Advantage |
$221.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$771.89
|
| Rate for Payer: Priority Health Medicare |
$224.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.51
|
| Rate for Payer: Railroad Medicare Medicare |
$221.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.76
|
| Rate for Payer: UHC Core |
$740.84
|
| Rate for Payer: UHC Exchange |
$221.81
|
| Rate for Payer: UHC Medicaid |
$156.42
|
| Rate for Payer: UHC Medicare Advantage |
$221.81
|
| Rate for Payer: UHCCP Medicaid |
$156.42
|
| Rate for Payer: VA VA |
$221.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.42
|
|
|
HC EXCISE LESION EYELID WITHOUT CLOSURE
|
Facility
|
IP
|
$887.23
|
|
|
Service Code
|
CPT 67840
|
| Hospital Charge Code |
36100521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$617.51 |
| Max. Negotiated Rate |
$798.51 |
| Rate for Payer: Aetna Commercial |
$754.15
|
| Rate for Payer: BCBS Trust/PPO |
$732.76
|
| Rate for Payer: BCN Commercial |
$732.76
|
| Rate for Payer: Cash Price |
$709.78
|
| Rate for Payer: Cofinity Commercial |
$763.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.78
|
| Rate for Payer: Healthscope Commercial |
$798.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.15
|
| Rate for Payer: Nomi Health Commercial |
$727.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$665.42
|
| Rate for Payer: PHP Commercial |
$754.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$771.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.76
|
| Rate for Payer: UHC Core |
$740.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.42
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,449.04 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$2,136.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,568.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,568.49
|
| Rate for Payer: BCBS Complete |
$1,521.37
|
| Rate for Payer: BCBS MAPPO |
$2,054.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,756.97
|
| Rate for Payer: BCN Commercial |
$6,756.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,054.79
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,054.79
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$1,449.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,157.53
|
| Rate for Payer: Meridian Medicaid |
$1,521.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,363.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,260.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,952.05
|
| Rate for Payer: PACE SWMI |
$2,054.79
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,054.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Medicare |
$2,075.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,054.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: UHC Exchange |
$2,054.79
|
| Rate for Payer: UHC Medicaid |
$1,449.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,054.79
|
| Rate for Payer: UHCCP Medicaid |
$1,449.04
|
| Rate for Payer: VA VA |
$2,054.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LESION MUCOSA & SBMCSL VESTIB CPLX RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40814
|
| Hospital Charge Code |
76100490
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,720.54 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: BCBS Trust/PPO |
$6,788.20
|
| Rate for Payer: BCN Commercial |
$6,788.20
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,449.04 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$2,136.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,568.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,568.49
|
| Rate for Payer: BCBS Complete |
$1,521.37
|
| Rate for Payer: BCBS MAPPO |
$2,054.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,756.97
|
| Rate for Payer: BCN Commercial |
$6,756.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,054.79
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,054.79
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$1,449.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,157.53
|
| Rate for Payer: Meridian Medicaid |
$1,521.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,363.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,260.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,952.05
|
| Rate for Payer: PACE SWMI |
$2,054.79
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,054.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Medicare |
$2,075.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,054.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: UHC Exchange |
$2,054.79
|
| Rate for Payer: UHC Medicaid |
$1,449.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,054.79
|
| Rate for Payer: UHCCP Medicaid |
$1,449.04
|
| Rate for Payer: VA VA |
$2,054.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40810
|
| Hospital Charge Code |
76100461
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,720.54 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: BCBS Trust/PPO |
$6,788.20
|
| Rate for Payer: BCN Commercial |
$6,788.20
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
IP
|
$4,043.82
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,814.50 |
| Max. Negotiated Rate |
$3,639.44 |
| Rate for Payer: Aetna Commercial |
$3,437.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,339.79
|
| Rate for Payer: BCN Commercial |
$3,339.79
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cofinity Commercial |
$3,477.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,235.06
|
| Rate for Payer: Healthscope Commercial |
$3,639.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,437.25
|
| Rate for Payer: Nomi Health Commercial |
$3,315.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,032.86
|
| Rate for Payer: PHP Commercial |
$3,437.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,518.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,814.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,558.56
|
| Rate for Payer: UHC Core |
$3,376.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,032.86
|
|
|
HC EXCISE LIP OR CHEEK FOLD
|
Facility
|
OP
|
$4,043.82
|
|
|
Service Code
|
CPT 40819
|
| Hospital Charge Code |
76100517
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$712.93 |
| Max. Negotiated Rate |
$3,639.44 |
| Rate for Payer: Aetna Commercial |
$3,437.25
|
| Rate for Payer: Aetna Medicare |
$1,051.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,263.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,263.69
|
| Rate for Payer: BCBS Complete |
$748.51
|
| Rate for Payer: BCBS MAPPO |
$1,010.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,324.42
|
| Rate for Payer: BCN Commercial |
$3,324.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,010.96
|
| Rate for Payer: Cash Price |
$3,235.06
|
| Rate for Payer: Cofinity Commercial |
$3,477.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,235.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,010.96
|
| Rate for Payer: Healthscope Commercial |
$3,639.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,032.86
|
| Rate for Payer: Mclaren Medicaid |
$712.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,061.50
|
| Rate for Payer: Meridian Medicaid |
$748.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,162.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,112.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,437.25
|
| Rate for Payer: Nomi Health Commercial |
$3,315.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,032.86
|
| Rate for Payer: PACE Senior Care Partners |
$960.41
|
| Rate for Payer: PACE SWMI |
$1,010.96
|
| Rate for Payer: PHP Commercial |
$3,437.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,010.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$712.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,518.12
|
| Rate for Payer: Priority Health Medicare |
$1,021.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,814.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,010.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,558.56
|
| Rate for Payer: UHC Core |
$3,376.59
|
| Rate for Payer: UHC Exchange |
$1,010.96
|
| Rate for Payer: UHC Medicaid |
$712.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,010.96
|
| Rate for Payer: UHCCP Medicaid |
$712.93
|
| Rate for Payer: VA VA |
$1,010.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,032.86
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$834.90 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: BCBS Trust/PPO |
$990.72
|
| Rate for Payer: BCN Commercial |
$990.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.5 CM OR LESS
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11640
|
| Hospital Charge Code |
76100110
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$311.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.87
|
| Rate for Payer: BCBS Complete |
$222.04
|
| Rate for Payer: BCBS MAPPO |
$299.89
|
| Rate for Payer: BCBS Trust/PPO |
$986.17
|
| Rate for Payer: BCN Commercial |
$986.17
|
| Rate for Payer: BCN Medicare Advantage |
$299.89
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.89
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Mclaren Medicaid |
$211.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.89
|
| Rate for Payer: Meridian Medicaid |
$222.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Senior Care Partners |
$284.90
|
| Rate for Payer: PACE SWMI |
$299.89
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$299.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Medicare |
$302.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: Railroad Medicare Medicare |
$299.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: UHC Exchange |
$299.89
|
| Rate for Payer: UHC Medicaid |
$211.48
|
| Rate for Payer: UHC Medicare Advantage |
$299.89
|
| Rate for Payer: UHCCP Medicaid |
$211.48
|
| Rate for Payer: VA VA |
$299.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$159.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.28
|
| Rate for Payer: BCBS Complete |
$113.30
|
| Rate for Payer: BCBS MAPPO |
$153.02
|
| Rate for Payer: BCBS Trust/PPO |
$503.19
|
| Rate for Payer: BCN Commercial |
$503.19
|
| Rate for Payer: BCN Medicare Advantage |
$153.02
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.02
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$107.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.67
|
| Rate for Payer: Meridian Medicaid |
$113.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Senior Care Partners |
$145.37
|
| Rate for Payer: PACE SWMI |
$153.02
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Medicare |
$154.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: Railroad Medicare Medicare |
$153.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: UHC Exchange |
$153.02
|
| Rate for Payer: UHC Medicaid |
$107.91
|
| Rate for Payer: UHC Medicare Advantage |
$153.02
|
| Rate for Payer: UHCCP Medicaid |
$107.91
|
| Rate for Payer: VA VA |
$153.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11641
|
| Hospital Charge Code |
76100111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.01 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: BCBS Trust/PPO |
$505.52
|
| Rate for Payer: BCN Commercial |
$505.52
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXCISE MALIGNANT LESION FACE, EARS, EYELIDS, NOSE, LIPS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11642
|
| Hospital Charge Code |
76100112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$159.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.28
|
| Rate for Payer: BCBS Complete |
$113.30
|
| Rate for Payer: BCBS MAPPO |
$153.02
|
| Rate for Payer: BCBS Trust/PPO |
$503.19
|
| Rate for Payer: BCN Commercial |
$503.19
|
| Rate for Payer: BCN Medicare Advantage |
$153.02
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.02
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$107.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.67
|
| Rate for Payer: Meridian Medicaid |
$113.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Senior Care Partners |
$145.37
|
| Rate for Payer: PACE SWMI |
$153.02
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Medicare |
$154.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: Railroad Medicare Medicare |
$153.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: UHC Exchange |
$153.02
|
| Rate for Payer: UHC Medicaid |
$107.91
|
| Rate for Payer: UHC Medicare Advantage |
$153.02
|
| Rate for Payer: UHCCP Medicaid |
$107.91
|
| Rate for Payer: VA VA |
$153.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
