|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
IP
|
$5,383.36
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$3,746.82 |
| Max. Negotiated Rate |
$4,845.02 |
| Rate for Payer: Aetna Commercial |
$4,575.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,446.12
|
| Rate for Payer: BCN Commercial |
$4,446.12
|
| Rate for Payer: Cash Price |
$4,306.69
|
| Rate for Payer: Cofinity Commercial |
$4,629.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.69
|
| Rate for Payer: Healthscope Commercial |
$4,845.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,037.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.86
|
| Rate for Payer: Nomi Health Commercial |
$4,414.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,037.52
|
| Rate for Payer: PHP Commercial |
$4,575.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,683.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,746.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,737.36
|
| Rate for Payer: UHC Core |
$4,495.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,037.52
|
|
|
HC EXCISION OF PENIS LESION(S)
|
Facility
|
OP
|
$5,383.36
|
|
|
Service Code
|
CPT 54060
|
| Hospital Charge Code |
76100347
|
|
Hospital Revenue Code
|
760
|
| Min. Negotiated Rate |
$949.09 |
| Max. Negotiated Rate |
$4,845.02 |
| Rate for Payer: Aetna Commercial |
$4,575.86
|
| Rate for Payer: Aetna Medicare |
$1,399.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,682.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,682.30
|
| Rate for Payer: BCBS Complete |
$996.46
|
| Rate for Payer: BCBS MAPPO |
$1,345.84
|
| Rate for Payer: BCBS Trust/PPO |
$4,425.66
|
| Rate for Payer: BCN Commercial |
$4,425.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,345.84
|
| Rate for Payer: Cash Price |
$4,306.69
|
| Rate for Payer: Cofinity Commercial |
$4,629.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,345.84
|
| Rate for Payer: Healthscope Commercial |
$4,845.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,037.52
|
| Rate for Payer: Mclaren Medicaid |
$949.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,413.13
|
| Rate for Payer: Meridian Medicaid |
$996.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,547.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,480.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.86
|
| Rate for Payer: Nomi Health Commercial |
$4,414.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,037.52
|
| Rate for Payer: PACE Senior Care Partners |
$1,278.55
|
| Rate for Payer: PACE SWMI |
$1,345.84
|
| Rate for Payer: PHP Commercial |
$4,575.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,345.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$949.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,683.52
|
| Rate for Payer: Priority Health Medicare |
$1,359.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,746.82
|
| Rate for Payer: Railroad Medicare Medicare |
$1,345.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,737.36
|
| Rate for Payer: UHC Core |
$4,495.11
|
| Rate for Payer: UHC Exchange |
$1,345.84
|
| Rate for Payer: UHC Medicaid |
$949.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.84
|
| Rate for Payer: UHCCP Medicaid |
$949.09
|
| Rate for Payer: VA VA |
$1,345.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,037.52
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
OP
|
$7,306.20
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,288.08 |
| Max. Negotiated Rate |
$6,575.58 |
| Rate for Payer: Aetna Commercial |
$6,210.27
|
| Rate for Payer: Aetna Medicare |
$1,899.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,283.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,283.19
|
| Rate for Payer: BCBS Complete |
$1,352.38
|
| Rate for Payer: BCBS MAPPO |
$1,826.55
|
| Rate for Payer: BCBS Trust/PPO |
$6,006.43
|
| Rate for Payer: BCN Commercial |
$6,006.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,826.55
|
| Rate for Payer: Cash Price |
$5,844.96
|
| Rate for Payer: Cofinity Commercial |
$6,283.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,844.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,826.55
|
| Rate for Payer: Healthscope Commercial |
$6,575.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,479.65
|
| Rate for Payer: Mclaren Medicaid |
$1,288.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,917.88
|
| Rate for Payer: Meridian Medicaid |
$1,352.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,100.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,009.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,210.27
|
| Rate for Payer: Nomi Health Commercial |
$5,991.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,479.65
|
| Rate for Payer: PACE Senior Care Partners |
$1,735.22
|
| Rate for Payer: PACE SWMI |
$1,826.55
|
| Rate for Payer: PHP Commercial |
$6,210.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,826.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,288.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,356.39
|
| Rate for Payer: Priority Health Medicare |
$1,844.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,085.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,826.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,429.46
|
| Rate for Payer: UHC Core |
$6,100.68
|
| Rate for Payer: UHC Exchange |
$1,826.55
|
| Rate for Payer: UHC Medicaid |
$1,288.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,826.55
|
| Rate for Payer: UHCCP Medicaid |
$1,288.08
|
| Rate for Payer: VA VA |
$1,826.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,479.65
|
|
|
HC EXCISION SOFT TISSUE PELVIS HIP SUBQ <3CM
|
Facility
|
IP
|
$7,306.20
|
|
|
Service Code
|
CPT 27047
|
| Hospital Charge Code |
76100439
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,085.12 |
| Max. Negotiated Rate |
$6,575.58 |
| Rate for Payer: Aetna Commercial |
$6,210.27
|
| Rate for Payer: BCBS Trust/PPO |
$6,034.19
|
| Rate for Payer: BCN Commercial |
$6,034.19
|
| Rate for Payer: Cash Price |
$5,844.96
|
| Rate for Payer: Cofinity Commercial |
$6,283.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,844.96
|
| Rate for Payer: Healthscope Commercial |
$6,575.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,479.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,210.27
|
| Rate for Payer: Nomi Health Commercial |
$5,991.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,479.65
|
| Rate for Payer: PHP Commercial |
$6,210.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,356.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,085.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,429.46
|
| Rate for Payer: UHC Core |
$6,100.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,479.65
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
OP
|
$8,284.71
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,460.59 |
| Max. Negotiated Rate |
$7,456.24 |
| Rate for Payer: Aetna Commercial |
$7,042.00
|
| Rate for Payer: Aetna Medicare |
$2,154.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,588.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,588.97
|
| Rate for Payer: BCBS Complete |
$1,533.50
|
| Rate for Payer: BCBS MAPPO |
$2,071.18
|
| Rate for Payer: BCBS Trust/PPO |
$6,810.86
|
| Rate for Payer: BCN Commercial |
$6,810.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,071.18
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,124.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,071.18
|
| Rate for Payer: Healthscope Commercial |
$7,456.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,213.53
|
| Rate for Payer: Mclaren Medicaid |
$1,460.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,174.74
|
| Rate for Payer: Meridian Medicaid |
$1,533.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,381.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,278.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,967.62
|
| Rate for Payer: PACE SWMI |
$2,071.18
|
| Rate for Payer: PHP Commercial |
$7,042.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,071.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,460.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,207.70
|
| Rate for Payer: Priority Health Medicare |
$2,091.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,766.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,071.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,290.54
|
| Rate for Payer: UHC Core |
$6,917.73
|
| Rate for Payer: UHC Exchange |
$2,071.18
|
| Rate for Payer: UHC Medicaid |
$1,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,071.18
|
| Rate for Payer: UHCCP Medicaid |
$1,460.59
|
| Rate for Payer: VA VA |
$2,071.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,213.53
|
|
|
HC EXCISION TONSIL TAGS
|
Facility
|
IP
|
$8,284.71
|
|
|
Service Code
|
CPT 42860
|
| Hospital Charge Code |
76100477
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,766.16 |
| Max. Negotiated Rate |
$7,456.24 |
| Rate for Payer: Aetna Commercial |
$7,042.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,842.34
|
| Rate for Payer: BCN Commercial |
$6,842.34
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,124.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Healthscope Commercial |
$7,456.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,213.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PHP Commercial |
$7,042.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,207.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,766.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,290.54
|
| Rate for Payer: UHC Core |
$6,917.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,213.53
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
OP
|
$4,720.29
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$832.19 |
| Max. Negotiated Rate |
$4,248.26 |
| Rate for Payer: Aetna Commercial |
$4,012.25
|
| Rate for Payer: Aetna Medicare |
$1,227.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,475.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,475.09
|
| Rate for Payer: BCBS Complete |
$873.73
|
| Rate for Payer: BCBS MAPPO |
$1,180.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,880.55
|
| Rate for Payer: BCN Commercial |
$3,880.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,180.07
|
| Rate for Payer: Cash Price |
$3,776.23
|
| Rate for Payer: Cofinity Commercial |
$4,059.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,776.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,180.07
|
| Rate for Payer: Healthscope Commercial |
$4,248.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,540.22
|
| Rate for Payer: Mclaren Medicaid |
$832.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,239.08
|
| Rate for Payer: Meridian Medicaid |
$873.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,357.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,298.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,012.25
|
| Rate for Payer: Nomi Health Commercial |
$3,870.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,540.22
|
| Rate for Payer: PACE Senior Care Partners |
$1,121.07
|
| Rate for Payer: PACE SWMI |
$1,180.07
|
| Rate for Payer: PHP Commercial |
$4,012.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,180.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$832.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,106.65
|
| Rate for Payer: Priority Health Medicare |
$1,191.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,285.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,180.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,153.86
|
| Rate for Payer: UHC Core |
$3,941.44
|
| Rate for Payer: UHC Exchange |
$1,180.07
|
| Rate for Payer: UHC Medicaid |
$832.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,180.07
|
| Rate for Payer: UHCCP Medicaid |
$832.19
|
| Rate for Payer: VA VA |
$1,180.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,540.22
|
|
|
HC EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Facility
|
IP
|
$4,720.29
|
|
|
Service Code
|
CPT 23075
|
| Hospital Charge Code |
76100412
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,285.32 |
| Max. Negotiated Rate |
$4,248.26 |
| Rate for Payer: Aetna Commercial |
$4,012.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,898.49
|
| Rate for Payer: BCN Commercial |
$3,898.49
|
| Rate for Payer: Cash Price |
$3,776.23
|
| Rate for Payer: Cofinity Commercial |
$4,059.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,776.23
|
| Rate for Payer: Healthscope Commercial |
$4,248.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,540.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,012.25
|
| Rate for Payer: Nomi Health Commercial |
$3,870.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,540.22
|
| Rate for Payer: PHP Commercial |
$4,012.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,106.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,285.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,153.86
|
| Rate for Payer: UHC Core |
$3,941.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,540.22
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,428.81 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$2,107.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,532.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,532.64
|
| Rate for Payer: BCBS Complete |
$1,500.13
|
| Rate for Payer: BCBS MAPPO |
$2,026.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,662.66
|
| Rate for Payer: BCN Commercial |
$6,662.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.11
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.11
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$1,428.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.42
|
| Rate for Payer: Meridian Medicaid |
$1,500.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,330.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,228.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,924.80
|
| Rate for Payer: PACE SWMI |
$2,026.11
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,428.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Medicare |
$2,046.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,026.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: UHC Exchange |
$2,026.11
|
| Rate for Payer: UHC Medicaid |
$1,428.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.11
|
| Rate for Payer: UHCCP Medicaid |
$1,428.81
|
| Rate for Payer: VA VA |
$2,026.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC EXCISION VAGINAL CYST/TUMOR
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 57135
|
| Hospital Charge Code |
76100333
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,640.69 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: BCBS Trust/PPO |
$6,693.46
|
| Rate for Payer: BCN Commercial |
$6,693.46
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
IP
|
$2,986.24
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,078.42 |
| Max. Negotiated Rate |
$2,687.62 |
| Rate for Payer: Aetna Commercial |
$2,538.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,466.34
|
| Rate for Payer: BCN Commercial |
$2,466.34
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Commercial |
$2,568.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Healthscope Commercial |
$2,687.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,239.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$2,448.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: PHP Commercial |
$2,538.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,598.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,078.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,627.89
|
| Rate for Payer: UHC Core |
$2,493.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,239.68
|
|
|
HC EXC LEG/ANKLE TUM < 3 CM
|
Facility
|
OP
|
$2,986.24
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
76100309
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$526.47 |
| Max. Negotiated Rate |
$2,687.62 |
| Rate for Payer: Aetna Commercial |
$2,538.30
|
| Rate for Payer: Aetna Medicare |
$776.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$933.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$933.20
|
| Rate for Payer: BCBS Complete |
$552.75
|
| Rate for Payer: BCBS MAPPO |
$746.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.99
|
| Rate for Payer: BCN Commercial |
$2,454.99
|
| Rate for Payer: BCN Medicare Advantage |
$746.56
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Commercial |
$2,568.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.56
|
| Rate for Payer: Healthscope Commercial |
$2,687.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,239.68
|
| Rate for Payer: Mclaren Medicaid |
$526.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.89
|
| Rate for Payer: Meridian Medicaid |
$552.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$858.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$2,448.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: PACE Senior Care Partners |
$709.23
|
| Rate for Payer: PACE SWMI |
$746.56
|
| Rate for Payer: PHP Commercial |
$2,538.30
|
| Rate for Payer: PHP Medicare Advantage |
$746.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,598.03
|
| Rate for Payer: Priority Health Medicare |
$754.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,078.42
|
| Rate for Payer: Railroad Medicare Medicare |
$746.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,627.89
|
| Rate for Payer: UHC Core |
$2,493.51
|
| Rate for Payer: UHC Exchange |
$746.56
|
| Rate for Payer: UHC Medicaid |
$526.47
|
| Rate for Payer: UHC Medicare Advantage |
$746.56
|
| Rate for Payer: UHCCP Medicaid |
$526.47
|
| Rate for Payer: VA VA |
$746.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,239.68
|
|
|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
OP
|
$4,353.36
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$767.50 |
| Max. Negotiated Rate |
$3,918.02 |
| Rate for Payer: Aetna Commercial |
$3,700.36
|
| Rate for Payer: Aetna Medicare |
$1,131.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,360.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,360.42
|
| Rate for Payer: BCBS Complete |
$805.81
|
| Rate for Payer: BCBS MAPPO |
$1,088.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,578.90
|
| Rate for Payer: BCN Commercial |
$3,578.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,088.34
|
| Rate for Payer: Cash Price |
$3,482.69
|
| Rate for Payer: Cofinity Commercial |
$3,743.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,482.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,088.34
|
| Rate for Payer: Healthscope Commercial |
$3,918.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,265.02
|
| Rate for Payer: Mclaren Medicaid |
$767.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,142.76
|
| Rate for Payer: Meridian Medicaid |
$805.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,251.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,197.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,700.36
|
| Rate for Payer: Nomi Health Commercial |
$3,569.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,265.02
|
| Rate for Payer: PACE Senior Care Partners |
$1,033.92
|
| Rate for Payer: PACE SWMI |
$1,088.34
|
| Rate for Payer: PHP Commercial |
$3,700.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,088.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$767.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,787.42
|
| Rate for Payer: Priority Health Medicare |
$1,099.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,029.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,088.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,830.96
|
| Rate for Payer: UHC Core |
$3,635.06
|
| Rate for Payer: UHC Exchange |
$1,088.34
|
| Rate for Payer: UHC Medicaid |
$767.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,088.34
|
| Rate for Payer: UHCCP Medicaid |
$767.50
|
| Rate for Payer: VA VA |
$1,088.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,265.02
|
|
|
HC EXC LESION MUCOSA SBMCSL VESTIBULE SMPL RPR
|
Facility
|
IP
|
$4,353.36
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
76100430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,029.94 |
| Max. Negotiated Rate |
$3,918.02 |
| Rate for Payer: Aetna Commercial |
$3,700.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,595.44
|
| Rate for Payer: BCN Commercial |
$3,595.44
|
| Rate for Payer: Cash Price |
$3,482.69
|
| Rate for Payer: Cofinity Commercial |
$3,743.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,482.69
|
| Rate for Payer: Healthscope Commercial |
$3,918.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,265.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,700.36
|
| Rate for Payer: Nomi Health Commercial |
$3,569.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,265.02
|
| Rate for Payer: PHP Commercial |
$3,700.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,787.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,029.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,830.96
|
| Rate for Payer: UHC Core |
$3,635.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,265.02
|
|
|
HC EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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 EXC LESION PALATE UVULA W/O CLOSURE
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
76100467
|
|
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 EXC LESION TONGUE W/CLOSURE
|
Facility
|
IP
|
$9,995.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
76100540
|
|
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 EXC LESION TONGUE W/CLOSURE
|
Facility
|
OP
|
$9,995.00
|
|
|
Service Code
|
CPT 41112
|
| Hospital Charge Code |
76100540
|
|
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 EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 40510
|
| Hospital Charge Code |
76100457
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11620
|
| Hospital Charge Code |
76100107
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 TO 1.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
76100108
|
|
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 EXC MALIGNANT LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.0 TO 2.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11622
|
| Hospital Charge Code |
76100109
|
|
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
|
|
