|
HC DESTR LESION ROOF OF MOUTH
|
Facility
|
IP
|
$8,109.00
|
|
|
Service Code
|
CPT 42160
|
| Hospital Charge Code |
76100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,270.85 |
| Max. Negotiated Rate |
$7,298.10 |
| Rate for Payer: Aetna Commercial |
$6,892.65
|
| Rate for Payer: BCBS Trust/PPO |
$6,619.38
|
| Rate for Payer: BCN Commercial |
$6,266.64
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$6,973.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Healthscope Commercial |
$7,298.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,081.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: PHP Commercial |
$6,892.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health HMO/PPO |
$7,054.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,433.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,135.92
|
| Rate for Payer: UHC Core |
$6,771.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,081.75
|
|
|
HC DESTR LESION ROOF OF MOUTH
|
Facility
|
OP
|
$8,109.00
|
|
|
Service Code
|
CPT 42160
|
| Hospital Charge Code |
76100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,925.89 |
| Max. Negotiated Rate |
$7,298.10 |
| Rate for Payer: Aetna Commercial |
$6,892.65
|
| Rate for Payer: Aetna Medicare |
$2,108.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,534.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,534.06
|
| Rate for Payer: BCBS Complete |
$2,462.14
|
| Rate for Payer: BCBS MAPPO |
$2,027.25
|
| Rate for Payer: BCBS Trust/PPO |
$6,666.41
|
| Rate for Payer: BCN Commercial |
$6,304.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,027.25
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$6,973.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,027.25
|
| Rate for Payer: Healthscope Commercial |
$7,298.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,081.75
|
| Rate for Payer: Mclaren Medicaid |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,128.61
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,331.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: PACE Senior Care Partners |
$1,925.89
|
| Rate for Payer: PACE SWMI |
$2,027.25
|
| Rate for Payer: PHP Commercial |
$6,892.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,027.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,344.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health HMO/PPO |
$7,054.83
|
| Rate for Payer: Priority Health Medicare |
$2,047.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,433.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,027.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,135.92
|
| Rate for Payer: UHC Core |
$6,771.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,027.25
|
| Rate for Payer: UHC Exchange |
$2,027.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,027.25
|
| Rate for Payer: UHCCP Medicaid |
$2,344.74
|
| Rate for Payer: VA VA |
$2,027.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,081.75
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
IP
|
$242.62
|
|
|
Service Code
|
CPT 17280
|
| Hospital Charge Code |
76100155
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.70 |
| Max. Negotiated Rate |
$218.36 |
| Rate for Payer: Aetna Commercial |
$206.23
|
| Rate for Payer: BCBS Trust/PPO |
$198.05
|
| Rate for Payer: BCN Commercial |
$187.50
|
| Rate for Payer: Cash Price |
$194.10
|
| Rate for Payer: Cofinity Commercial |
$208.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.10
|
| Rate for Payer: Healthscope Commercial |
$218.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.23
|
| Rate for Payer: Nomi Health Commercial |
$198.95
|
| Rate for Payer: PHP Commercial |
$206.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.70
|
| Rate for Payer: Priority Health HMO/PPO |
$211.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.51
|
| Rate for Payer: UHC Core |
$202.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.97
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
OP
|
$242.62
|
|
|
Service Code
|
CPT 17280
|
| Hospital Charge Code |
76100155
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.62 |
| Max. Negotiated Rate |
$218.36 |
| Rate for Payer: Aetna Commercial |
$206.23
|
| Rate for Payer: Aetna Medicare |
$63.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.82
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$60.66
|
| Rate for Payer: BCBS Trust/PPO |
$199.46
|
| Rate for Payer: BCN Commercial |
$188.64
|
| Rate for Payer: BCN Medicare Advantage |
$60.66
|
| Rate for Payer: Cash Price |
$194.10
|
| Rate for Payer: Cash Price |
$194.10
|
| Rate for Payer: Cofinity Commercial |
$208.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.66
|
| Rate for Payer: Healthscope Commercial |
$218.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.97
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.69
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.23
|
| Rate for Payer: Nomi Health Commercial |
$198.95
|
| Rate for Payer: PACE Senior Care Partners |
$57.62
|
| Rate for Payer: PACE SWMI |
$60.66
|
| Rate for Payer: PHP Commercial |
$206.23
|
| Rate for Payer: PHP Medicare Advantage |
$60.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.70
|
| Rate for Payer: Priority Health HMO/PPO |
$211.08
|
| Rate for Payer: Priority Health Medicare |
$61.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.56
|
| Rate for Payer: Railroad Medicare Medicare |
$60.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.51
|
| Rate for Payer: UHC Core |
$202.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.66
|
| Rate for Payer: UHC Exchange |
$60.66
|
| Rate for Payer: UHC Medicare Advantage |
$60.66
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$60.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.97
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
OP
|
$392.23
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$353.01 |
| Rate for Payer: Aetna Commercial |
$333.40
|
| Rate for Payer: Aetna Medicare |
$101.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.57
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$98.06
|
| Rate for Payer: BCBS Trust/PPO |
$322.45
|
| Rate for Payer: BCN Commercial |
$304.96
|
| Rate for Payer: BCN Medicare Advantage |
$98.06
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$337.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.06
|
| Rate for Payer: Healthscope Commercial |
$353.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.17
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.96
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: Nomi Health Commercial |
$321.63
|
| Rate for Payer: PACE Senior Care Partners |
$93.15
|
| Rate for Payer: PACE SWMI |
$98.06
|
| Rate for Payer: PHP Commercial |
$333.40
|
| Rate for Payer: PHP Medicare Advantage |
$98.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health HMO/PPO |
$341.24
|
| Rate for Payer: Priority Health Medicare |
$99.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.79
|
| Rate for Payer: Railroad Medicare Medicare |
$98.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.16
|
| Rate for Payer: UHC Core |
$327.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.06
|
| Rate for Payer: UHC Exchange |
$98.06
|
| Rate for Payer: UHC Medicare Advantage |
$98.06
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$98.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.17
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
IP
|
$392.23
|
|
|
Service Code
|
CPT 17281
|
| Hospital Charge Code |
76100147
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.95 |
| Max. Negotiated Rate |
$353.01 |
| Rate for Payer: Aetna Commercial |
$333.40
|
| Rate for Payer: BCBS Trust/PPO |
$320.18
|
| Rate for Payer: BCN Commercial |
$303.12
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$337.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Healthscope Commercial |
$353.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: Nomi Health Commercial |
$321.63
|
| Rate for Payer: PHP Commercial |
$333.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health HMO/PPO |
$341.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.16
|
| Rate for Payer: UHC Core |
$327.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.17
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
OP
|
$392.23
|
|
|
Service Code
|
CPT 17283
|
| Hospital Charge Code |
76100156
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$353.01 |
| Rate for Payer: Aetna Commercial |
$333.40
|
| Rate for Payer: Aetna Medicare |
$101.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.57
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$98.06
|
| Rate for Payer: BCBS Trust/PPO |
$322.45
|
| Rate for Payer: BCN Commercial |
$304.96
|
| Rate for Payer: BCN Medicare Advantage |
$98.06
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$337.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.06
|
| Rate for Payer: Healthscope Commercial |
$353.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.17
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.96
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: Nomi Health Commercial |
$321.63
|
| Rate for Payer: PACE Senior Care Partners |
$93.15
|
| Rate for Payer: PACE SWMI |
$98.06
|
| Rate for Payer: PHP Commercial |
$333.40
|
| Rate for Payer: PHP Medicare Advantage |
$98.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health HMO/PPO |
$341.24
|
| Rate for Payer: Priority Health Medicare |
$99.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.79
|
| Rate for Payer: Railroad Medicare Medicare |
$98.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.16
|
| Rate for Payer: UHC Core |
$327.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.06
|
| Rate for Payer: UHC Exchange |
$98.06
|
| Rate for Payer: UHC Medicare Advantage |
$98.06
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$98.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.17
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
IP
|
$392.23
|
|
|
Service Code
|
CPT 17283
|
| Hospital Charge Code |
76100156
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.95 |
| Max. Negotiated Rate |
$353.01 |
| Rate for Payer: Aetna Commercial |
$333.40
|
| Rate for Payer: BCBS Trust/PPO |
$320.18
|
| Rate for Payer: BCN Commercial |
$303.12
|
| Rate for Payer: Cash Price |
$313.78
|
| Rate for Payer: Cofinity Commercial |
$337.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.78
|
| Rate for Payer: Healthscope Commercial |
$353.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.40
|
| Rate for Payer: Nomi Health Commercial |
$321.63
|
| Rate for Payer: PHP Commercial |
$333.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.95
|
| Rate for Payer: Priority Health HMO/PPO |
$341.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.16
|
| Rate for Payer: UHC Core |
$327.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.17
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
IP
|
$602.39
|
|
|
Service Code
|
CPT 17284
|
| Hospital Charge Code |
76100157
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.55 |
| Max. Negotiated Rate |
$542.15 |
| Rate for Payer: Aetna Commercial |
$512.03
|
| Rate for Payer: BCBS Trust/PPO |
$491.73
|
| Rate for Payer: BCN Commercial |
$465.53
|
| Rate for Payer: Cash Price |
$481.91
|
| Rate for Payer: Cofinity Commercial |
$518.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.91
|
| Rate for Payer: Healthscope Commercial |
$542.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.03
|
| Rate for Payer: Nomi Health Commercial |
$493.96
|
| Rate for Payer: PHP Commercial |
$512.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.55
|
| Rate for Payer: Priority Health HMO/PPO |
$524.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.10
|
| Rate for Payer: UHC Core |
$503.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.79
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
OP
|
$602.39
|
|
|
Service Code
|
CPT 17284
|
| Hospital Charge Code |
76100157
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.07 |
| Max. Negotiated Rate |
$542.15 |
| Rate for Payer: Aetna Commercial |
$512.03
|
| Rate for Payer: Aetna Medicare |
$156.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.25
|
| Rate for Payer: BCBS Complete |
$464.73
|
| Rate for Payer: BCBS MAPPO |
$150.60
|
| Rate for Payer: BCBS Trust/PPO |
$495.22
|
| Rate for Payer: BCN Commercial |
$468.36
|
| Rate for Payer: BCN Medicare Advantage |
$150.60
|
| Rate for Payer: Cash Price |
$481.91
|
| Rate for Payer: Cash Price |
$481.91
|
| Rate for Payer: Cofinity Commercial |
$518.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.60
|
| Rate for Payer: Healthscope Commercial |
$542.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.79
|
| Rate for Payer: Mclaren Medicaid |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.13
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.03
|
| Rate for Payer: Nomi Health Commercial |
$493.96
|
| Rate for Payer: PACE Senior Care Partners |
$143.07
|
| Rate for Payer: PACE SWMI |
$150.60
|
| Rate for Payer: PHP Commercial |
$512.03
|
| Rate for Payer: PHP Medicare Advantage |
$150.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.55
|
| Rate for Payer: Priority Health HMO/PPO |
$524.08
|
| Rate for Payer: Priority Health Medicare |
$152.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.60
|
| Rate for Payer: Railroad Medicare Medicare |
$150.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.10
|
| Rate for Payer: UHC Core |
$503.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.60
|
| Rate for Payer: UHC Exchange |
$150.60
|
| Rate for Payer: UHC Medicare Advantage |
$150.60
|
| Rate for Payer: UHCCP Medicaid |
$442.57
|
| Rate for Payer: VA VA |
$150.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.79
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
OP
|
$602.39
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.07 |
| Max. Negotiated Rate |
$542.15 |
| Rate for Payer: Aetna Commercial |
$512.03
|
| Rate for Payer: Aetna Medicare |
$156.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.25
|
| Rate for Payer: BCBS Complete |
$464.73
|
| Rate for Payer: BCBS MAPPO |
$150.60
|
| Rate for Payer: BCBS Trust/PPO |
$495.22
|
| Rate for Payer: BCN Commercial |
$468.36
|
| Rate for Payer: BCN Medicare Advantage |
$150.60
|
| Rate for Payer: Cash Price |
$481.91
|
| Rate for Payer: Cash Price |
$481.91
|
| Rate for Payer: Cofinity Commercial |
$518.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.60
|
| Rate for Payer: Healthscope Commercial |
$542.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.79
|
| Rate for Payer: Mclaren Medicaid |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.13
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.03
|
| Rate for Payer: Nomi Health Commercial |
$493.96
|
| Rate for Payer: PACE Senior Care Partners |
$143.07
|
| Rate for Payer: PACE SWMI |
$150.60
|
| Rate for Payer: PHP Commercial |
$512.03
|
| Rate for Payer: PHP Medicare Advantage |
$150.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.55
|
| Rate for Payer: Priority Health HMO/PPO |
$524.08
|
| Rate for Payer: Priority Health Medicare |
$152.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.60
|
| Rate for Payer: Railroad Medicare Medicare |
$150.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.10
|
| Rate for Payer: UHC Core |
$503.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.60
|
| Rate for Payer: UHC Exchange |
$150.60
|
| Rate for Payer: UHC Medicare Advantage |
$150.60
|
| Rate for Payer: UHCCP Medicaid |
$442.57
|
| Rate for Payer: VA VA |
$150.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.79
|
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
IP
|
$602.39
|
|
|
Service Code
|
CPT 17286
|
| Hospital Charge Code |
76100158
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.55 |
| Max. Negotiated Rate |
$542.15 |
| Rate for Payer: Aetna Commercial |
$512.03
|
| Rate for Payer: BCBS Trust/PPO |
$491.73
|
| Rate for Payer: BCN Commercial |
$465.53
|
| Rate for Payer: Cash Price |
$481.91
|
| Rate for Payer: Cofinity Commercial |
$518.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.91
|
| Rate for Payer: Healthscope Commercial |
$542.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.03
|
| Rate for Payer: Nomi Health Commercial |
$493.96
|
| Rate for Payer: PHP Commercial |
$512.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.55
|
| Rate for Payer: Priority Health HMO/PPO |
$524.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.10
|
| Rate for Payer: UHC Core |
$503.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.79
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
OP
|
$176.87
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.01 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: Aetna Medicare |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.27
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$145.40
|
| Rate for Payer: BCN Commercial |
$137.52
|
| Rate for Payer: BCN Medicare Advantage |
$44.22
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.22
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.65
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.43
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: PACE Senior Care Partners |
$42.01
|
| Rate for Payer: PACE SWMI |
$44.22
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: PHP Medicare Advantage |
$44.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.97
|
| Rate for Payer: Priority Health HMO/PPO |
$153.88
|
| Rate for Payer: Priority Health Medicare |
$44.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.50
|
| Rate for Payer: Railroad Medicare Medicare |
$44.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.65
|
| Rate for Payer: UHC Core |
$147.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.22
|
| Rate for Payer: UHC Exchange |
$44.22
|
| Rate for Payer: UHC Medicare Advantage |
$44.22
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$44.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.65
|
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
IP
|
$176.87
|
|
|
Service Code
|
CPT 54056
|
| Hospital Charge Code |
76100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.97 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: BCBS Trust/PPO |
$144.38
|
| Rate for Payer: BCN Commercial |
$136.69
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.97
|
| Rate for Payer: Priority Health HMO/PPO |
$153.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.65
|
| Rate for Payer: UHC Core |
$147.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.65
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
IP
|
$490.03
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.52 |
| Max. Negotiated Rate |
$441.03 |
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: BCBS Trust/PPO |
$400.01
|
| Rate for Payer: BCN Commercial |
$378.70
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$421.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Healthscope Commercial |
$441.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: Nomi Health Commercial |
$401.82
|
| Rate for Payer: PHP Commercial |
$416.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health HMO/PPO |
$426.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.23
|
| Rate for Payer: UHC Core |
$409.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
OP
|
$490.03
|
|
|
Service Code
|
CPT 46900
|
| Hospital Charge Code |
76100219
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.38 |
| Max. Negotiated Rate |
$441.03 |
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: Aetna Medicare |
$127.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.13
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$122.51
|
| Rate for Payer: BCBS Trust/PPO |
$402.85
|
| Rate for Payer: BCN Commercial |
$381.00
|
| Rate for Payer: BCN Medicare Advantage |
$122.51
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$421.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.51
|
| Rate for Payer: Healthscope Commercial |
$441.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.52
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.63
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: Nomi Health Commercial |
$401.82
|
| Rate for Payer: PACE Senior Care Partners |
$116.38
|
| Rate for Payer: PACE SWMI |
$122.51
|
| Rate for Payer: PHP Commercial |
$416.53
|
| Rate for Payer: PHP Medicare Advantage |
$122.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health HMO/PPO |
$426.33
|
| Rate for Payer: Priority Health Medicare |
$123.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.32
|
| Rate for Payer: Railroad Medicare Medicare |
$122.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.23
|
| Rate for Payer: UHC Core |
$409.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.51
|
| Rate for Payer: UHC Exchange |
$122.51
|
| Rate for Payer: UHC Medicare Advantage |
$122.51
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$122.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.43 |
| Max. Negotiated Rate |
$150.85 |
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: Aetna Medicare |
$42.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.57
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$40.45
|
| Rate for Payer: BCBS Trust/PPO |
$133.03
|
| Rate for Payer: BCN Commercial |
$125.82
|
| Rate for Payer: BCN Medicare Advantage |
$40.45
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.45
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PACE Senior Care Partners |
$38.43
|
| Rate for Payer: PACE SWMI |
$40.45
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO |
$140.78
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.42
|
| Rate for Payer: Railroad Medicare Medicare |
$40.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.40
|
| Rate for Payer: UHC Core |
$135.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.45
|
| Rate for Payer: UHC Exchange |
$40.45
|
| Rate for Payer: UHC Medicare Advantage |
$40.45
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$40.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT BENIGN LESIONS 15 OR MORE
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17111
|
| Hospital Charge Code |
76100124
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.18 |
| Max. Negotiated Rate |
$145.64 |
| Rate for Payer: Aetna Commercial |
$137.55
|
| Rate for Payer: BCBS Trust/PPO |
$132.09
|
| Rate for Payer: BCN Commercial |
$125.05
|
| Rate for Payer: Cash Price |
$129.46
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.46
|
| Rate for Payer: Healthscope Commercial |
$145.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.55
|
| Rate for Payer: Nomi Health Commercial |
$132.69
|
| Rate for Payer: PHP Commercial |
$137.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.18
|
| Rate for Payer: Priority Health HMO/PPO |
$140.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.40
|
| Rate for Payer: UHC Core |
$135.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.36
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
IP
|
$176.53
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.74 |
| Max. Negotiated Rate |
$158.88 |
| Rate for Payer: Aetna Commercial |
$150.05
|
| Rate for Payer: BCBS Trust/PPO |
$144.10
|
| Rate for Payer: BCN Commercial |
$136.42
|
| Rate for Payer: Cash Price |
$141.22
|
| Rate for Payer: Cofinity Commercial |
$151.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.22
|
| Rate for Payer: Healthscope Commercial |
$158.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.05
|
| Rate for Payer: Nomi Health Commercial |
$144.75
|
| Rate for Payer: PHP Commercial |
$150.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.74
|
| Rate for Payer: Priority Health HMO/PPO |
$153.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.35
|
| Rate for Payer: UHC Core |
$147.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.40
|
|
|
HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS
|
Facility
|
OP
|
$176.53
|
|
|
Service Code
|
CPT 17110
|
| Hospital Charge Code |
76100123
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.93 |
| Max. Negotiated Rate |
$158.88 |
| Rate for Payer: Aetna Commercial |
$150.05
|
| Rate for Payer: Aetna Medicare |
$45.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.17
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$44.13
|
| Rate for Payer: BCBS Trust/PPO |
$145.13
|
| Rate for Payer: BCN Commercial |
$137.25
|
| Rate for Payer: BCN Medicare Advantage |
$44.13
|
| Rate for Payer: Cash Price |
$141.22
|
| Rate for Payer: Cash Price |
$141.22
|
| Rate for Payer: Cofinity Commercial |
$151.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.13
|
| Rate for Payer: Healthscope Commercial |
$158.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.40
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.34
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.05
|
| Rate for Payer: Nomi Health Commercial |
$144.75
|
| Rate for Payer: PACE Senior Care Partners |
$41.93
|
| Rate for Payer: PACE SWMI |
$44.13
|
| Rate for Payer: PHP Commercial |
$150.05
|
| Rate for Payer: PHP Medicare Advantage |
$44.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.74
|
| Rate for Payer: Priority Health HMO/PPO |
$153.58
|
| Rate for Payer: Priority Health Medicare |
$44.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.28
|
| Rate for Payer: Railroad Medicare Medicare |
$44.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.35
|
| Rate for Payer: UHC Core |
$147.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.13
|
| Rate for Payer: UHC Exchange |
$44.13
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$44.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.40
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
OP
|
$1,435.75
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$340.99 |
| Max. Negotiated Rate |
$1,292.17 |
| Rate for Payer: Aetna Commercial |
$1,220.39
|
| Rate for Payer: Aetna Medicare |
$373.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$448.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$448.67
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$358.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.33
|
| Rate for Payer: BCN Commercial |
$1,116.30
|
| Rate for Payer: BCN Medicare Advantage |
$358.94
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.94
|
| Rate for Payer: Healthscope Commercial |
$1,292.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,076.81
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$376.88
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$412.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.39
|
| Rate for Payer: Nomi Health Commercial |
$1,177.32
|
| Rate for Payer: PACE Senior Care Partners |
$340.99
|
| Rate for Payer: PACE SWMI |
$358.94
|
| Rate for Payer: PHP Commercial |
$1,220.39
|
| Rate for Payer: PHP Medicare Advantage |
$358.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.24
|
| Rate for Payer: Priority Health HMO/PPO |
$1,249.10
|
| Rate for Payer: Priority Health Medicare |
$362.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$961.95
|
| Rate for Payer: Railroad Medicare Medicare |
$358.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,263.46
|
| Rate for Payer: UHC Core |
$1,198.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$358.94
|
| Rate for Payer: UHC Exchange |
$358.94
|
| Rate for Payer: UHC Medicare Advantage |
$358.94
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$358.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,076.81
|
|
|
HC DESTRUCT BY NEURO AGENT SUP HYPOGAST PLEXUS
|
Facility
|
IP
|
$1,435.75
|
|
|
Service Code
|
CPT 64681
|
| Hospital Charge Code |
36100606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$933.24 |
| Max. Negotiated Rate |
$1,292.17 |
| Rate for Payer: Aetna Commercial |
$1,220.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,172.00
|
| Rate for Payer: BCN Commercial |
$1,109.55
|
| Rate for Payer: Cash Price |
$1,148.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,148.60
|
| Rate for Payer: Healthscope Commercial |
$1,292.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,076.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,220.39
|
| Rate for Payer: Nomi Health Commercial |
$1,177.32
|
| Rate for Payer: PHP Commercial |
$1,220.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.24
|
| Rate for Payer: Priority Health HMO/PPO |
$1,249.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$961.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,263.46
|
| Rate for Payer: UHC Core |
$1,198.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,076.81
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
IP
|
$2,683.19
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.07 |
| Max. Negotiated Rate |
$2,414.87 |
| Rate for Payer: Aetna Commercial |
$2,280.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.29
|
| Rate for Payer: BCN Commercial |
$2,073.57
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,307.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Healthscope Commercial |
$2,414.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: PHP Commercial |
$2,280.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.21
|
| Rate for Payer: UHC Core |
$2,240.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.39
|
|
|
HC DESTRUCT BY NEURO AGENT TRIGEM NRVE
|
Facility
|
OP
|
$2,683.19
|
|
|
Service Code
|
CPT 64610
|
| Hospital Charge Code |
36100607
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.26 |
| Max. Negotiated Rate |
$2,414.87 |
| Rate for Payer: Aetna Commercial |
$2,280.71
|
| Rate for Payer: Aetna Medicare |
$697.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$838.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$838.50
|
| Rate for Payer: BCBS Complete |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$670.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,205.85
|
| Rate for Payer: BCN Commercial |
$2,086.18
|
| Rate for Payer: BCN Medicare Advantage |
$670.80
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,307.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.80
|
| Rate for Payer: Healthscope Commercial |
$2,414.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.39
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.34
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$771.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: PACE Senior Care Partners |
$637.26
|
| Rate for Payer: PACE SWMI |
$670.80
|
| Rate for Payer: PHP Commercial |
$2,280.71
|
| Rate for Payer: PHP Medicare Advantage |
$670.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.38
|
| Rate for Payer: Priority Health Medicare |
$677.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.74
|
| Rate for Payer: Railroad Medicare Medicare |
$670.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.21
|
| Rate for Payer: UHC Core |
$2,240.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.80
|
| Rate for Payer: UHC Exchange |
$670.80
|
| Rate for Payer: UHC Medicare Advantage |
$670.80
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.39
|
|
|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
IP
|
$2,532.45
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,646.09 |
| Max. Negotiated Rate |
$2,279.20 |
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,067.24
|
| Rate for Payer: BCN Commercial |
$1,957.08
|
| Rate for Payer: Cash Price |
$2,025.96
|
| Rate for Payer: Cofinity Commercial |
$2,177.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,025.96
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,203.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,228.56
|
| Rate for Payer: UHC Core |
$2,114.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
