|
HC DESTRUCTION LESION(S) VULVA, EXTENSIVE
|
Facility
|
OP
|
$2,532.45
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
76100235
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$601.46 |
| Max. Negotiated Rate |
$2,279.20 |
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: Aetna Medicare |
$658.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.39
|
| Rate for Payer: BCBS Complete |
$1,388.75
|
| Rate for Payer: BCBS MAPPO |
$633.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,081.93
|
| Rate for Payer: BCN Commercial |
$1,968.98
|
| Rate for Payer: BCN Medicare Advantage |
$633.11
|
| Rate for Payer: Cash Price |
$2,025.96
|
| 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: Health Alliance Plan Medicare Advantage |
$633.11
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Mclaren Medicaid |
$1,322.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.77
|
| Rate for Payer: Meridian Medicaid |
$1,388.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: PACE Senior Care Partners |
$601.46
|
| Rate for Payer: PACE SWMI |
$633.11
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: PHP Medicare Advantage |
$633.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,322.53
|
| 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 Medicare |
$639.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.74
|
| Rate for Payer: Railroad Medicare Medicare |
$633.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,228.56
|
| Rate for Payer: UHC Core |
$2,114.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.11
|
| Rate for Payer: UHC Exchange |
$633.11
|
| Rate for Payer: UHC Medicare Advantage |
$633.11
|
| Rate for Payer: UHCCP Medicaid |
$1,322.53
|
| Rate for Payer: VA VA |
$633.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
IP
|
$2,532.45
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
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
|
|
|
HC DESTRUCTION LESION(S) VULVA, SIMPLE
|
Facility
|
OP
|
$2,532.45
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
76100233
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$601.46 |
| Max. Negotiated Rate |
$2,279.20 |
| Rate for Payer: Aetna Commercial |
$2,152.58
|
| Rate for Payer: Aetna Medicare |
$658.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.39
|
| Rate for Payer: BCBS Complete |
$1,388.75
|
| Rate for Payer: BCBS MAPPO |
$633.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,081.93
|
| Rate for Payer: BCN Commercial |
$1,968.98
|
| Rate for Payer: BCN Medicare Advantage |
$633.11
|
| Rate for Payer: Cash Price |
$2,025.96
|
| 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: Health Alliance Plan Medicare Advantage |
$633.11
|
| Rate for Payer: Healthscope Commercial |
$2,279.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,899.34
|
| Rate for Payer: Mclaren Medicaid |
$1,322.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$664.77
|
| Rate for Payer: Meridian Medicaid |
$1,388.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,152.58
|
| Rate for Payer: Nomi Health Commercial |
$2,076.61
|
| Rate for Payer: PACE Senior Care Partners |
$601.46
|
| Rate for Payer: PACE SWMI |
$633.11
|
| Rate for Payer: PHP Commercial |
$2,152.58
|
| Rate for Payer: PHP Medicare Advantage |
$633.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,322.53
|
| 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 Medicare |
$639.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.74
|
| Rate for Payer: Railroad Medicare Medicare |
$633.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,228.56
|
| Rate for Payer: UHC Core |
$2,114.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.11
|
| Rate for Payer: UHC Exchange |
$633.11
|
| Rate for Payer: UHC Medicare Advantage |
$633.11
|
| Rate for Payer: UHCCP Medicaid |
$1,322.53
|
| Rate for Payer: VA VA |
$633.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,899.34
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
IP
|
$1,065.05
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$692.28 |
| Max. Negotiated Rate |
$958.54 |
| Rate for Payer: Aetna Commercial |
$905.29
|
| Rate for Payer: BCBS Trust/PPO |
$869.40
|
| Rate for Payer: BCN Commercial |
$823.07
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cofinity Commercial |
$915.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.04
|
| Rate for Payer: Healthscope Commercial |
$958.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.29
|
| Rate for Payer: Nomi Health Commercial |
$873.34
|
| Rate for Payer: PHP Commercial |
$905.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.28
|
| Rate for Payer: Priority Health HMO/PPO |
$926.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.24
|
| Rate for Payer: UHC Core |
$889.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.79
|
|
|
HC DESTRUCTION PENIS LESION(S) CHEMICAL
|
Facility
|
OP
|
$1,065.05
|
|
|
Service Code
|
CPT 54050
|
| Hospital Charge Code |
76100346
|
| Min. Negotiated Rate |
$252.95 |
| Max. Negotiated Rate |
$958.54 |
| Rate for Payer: Aetna Commercial |
$905.29
|
| Rate for Payer: Aetna Medicare |
$276.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$332.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$332.83
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$266.26
|
| Rate for Payer: BCBS Trust/PPO |
$875.58
|
| Rate for Payer: BCN Commercial |
$828.08
|
| Rate for Payer: BCN Medicare Advantage |
$266.26
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cash Price |
$852.04
|
| Rate for Payer: Cofinity Commercial |
$915.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.26
|
| Rate for Payer: Healthscope Commercial |
$958.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.79
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.58
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$306.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.29
|
| Rate for Payer: Nomi Health Commercial |
$873.34
|
| Rate for Payer: PACE Senior Care Partners |
$252.95
|
| Rate for Payer: PACE SWMI |
$266.26
|
| Rate for Payer: PHP Commercial |
$905.29
|
| Rate for Payer: PHP Medicare Advantage |
$266.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.28
|
| Rate for Payer: Priority Health HMO/PPO |
$926.59
|
| Rate for Payer: Priority Health Medicare |
$268.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.58
|
| Rate for Payer: Railroad Medicare Medicare |
$266.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.24
|
| Rate for Payer: UHC Core |
$889.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.26
|
| Rate for Payer: UHC Exchange |
$266.26
|
| Rate for Payer: UHC Medicare Advantage |
$266.26
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$266.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.79
|
|
|
HC DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$392.23
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
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 DESTRUCT MALIG LESION FACE,EAR,EYELID,NOSE,LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$392.23
|
|
|
Service Code
|
CPT 17282
|
| Hospital Charge Code |
76100131
|
|
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 DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
OP
|
$219.52
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$52.14 |
| Max. Negotiated Rate |
$197.57 |
| Rate for Payer: Aetna Commercial |
$186.59
|
| Rate for Payer: Aetna Medicare |
$57.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.60
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$54.88
|
| Rate for Payer: BCBS Trust/PPO |
$180.47
|
| Rate for Payer: BCN Commercial |
$170.68
|
| Rate for Payer: BCN Medicare Advantage |
$54.88
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$188.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.88
|
| Rate for Payer: Healthscope Commercial |
$197.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.64
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.62
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.59
|
| Rate for Payer: Nomi Health Commercial |
$180.01
|
| Rate for Payer: PACE Senior Care Partners |
$52.14
|
| Rate for Payer: PACE SWMI |
$54.88
|
| Rate for Payer: PHP Commercial |
$186.59
|
| Rate for Payer: PHP Medicare Advantage |
$54.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.69
|
| Rate for Payer: Priority Health HMO/PPO |
$190.98
|
| Rate for Payer: Priority Health Medicare |
$55.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.08
|
| Rate for Payer: Railroad Medicare Medicare |
$54.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.18
|
| Rate for Payer: UHC Core |
$183.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.88
|
| Rate for Payer: UHC Exchange |
$54.88
|
| Rate for Payer: UHC Medicare Advantage |
$54.88
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$54.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.64
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA <0.6 CM
|
Facility
|
IP
|
$219.52
|
|
|
Service Code
|
CPT 17270
|
| Hospital Charge Code |
76100154
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.69 |
| Max. Negotiated Rate |
$197.57 |
| Rate for Payer: Aetna Commercial |
$186.59
|
| Rate for Payer: BCBS Trust/PPO |
$179.19
|
| Rate for Payer: BCN Commercial |
$169.65
|
| Rate for Payer: Cash Price |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$188.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.62
|
| Rate for Payer: Healthscope Commercial |
$197.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.59
|
| Rate for Payer: Nomi Health Commercial |
$180.01
|
| Rate for Payer: PHP Commercial |
$186.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.69
|
| Rate for Payer: Priority Health HMO/PPO |
$190.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.18
|
| Rate for Payer: UHC Core |
$183.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.64
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: BCBS Trust/PPO |
$229.86
|
| Rate for Payer: BCN Commercial |
$217.61
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 17271
|
| Hospital Charge Code |
76100128
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.88 |
| Max. Negotiated Rate |
$253.43 |
| Rate for Payer: Aetna Commercial |
$239.35
|
| Rate for Payer: Aetna Medicare |
$73.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.00
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$231.50
|
| Rate for Payer: BCN Commercial |
$218.94
|
| Rate for Payer: BCN Medicare Advantage |
$70.40
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$242.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$253.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.19
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.92
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Senior Care Partners |
$66.88
|
| Rate for Payer: PACE SWMI |
$70.40
|
| Rate for Payer: PHP Commercial |
$239.35
|
| Rate for Payer: PHP Medicare Advantage |
$70.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO |
$244.98
|
| Rate for Payer: Priority Health Medicare |
$71.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.67
|
| Rate for Payer: Railroad Medicare Medicare |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.80
|
| Rate for Payer: UHC Core |
$235.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.40
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$70.40
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.19
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
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 MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17272
|
| Hospital Charge Code |
76100129
|
|
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 MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
OP
|
$309.75
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$73.57 |
| Max. Negotiated Rate |
$303.32 |
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: Aetna Medicare |
$80.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.80
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$77.44
|
| Rate for Payer: BCBS Trust/PPO |
$254.65
|
| Rate for Payer: BCN Commercial |
$240.83
|
| Rate for Payer: BCN Medicare Advantage |
$77.44
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.44
|
| Rate for Payer: Healthscope Commercial |
$278.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.31
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.31
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: PACE Senior Care Partners |
$73.57
|
| Rate for Payer: PACE SWMI |
$77.44
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: PHP Medicare Advantage |
$77.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO |
$269.48
|
| Rate for Payer: Priority Health Medicare |
$78.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.53
|
| Rate for Payer: Railroad Medicare Medicare |
$77.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.58
|
| Rate for Payer: UHC Core |
$258.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.44
|
| Rate for Payer: UHC Exchange |
$77.44
|
| Rate for Payer: UHC Medicare Advantage |
$77.44
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$77.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.31
|
|
|
HC DESTRUCT MALIG LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$309.75
|
|
|
Service Code
|
CPT 17273
|
| Hospital Charge Code |
76100130
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.34 |
| Max. Negotiated Rate |
$278.77 |
| Rate for Payer: Aetna Commercial |
$263.29
|
| Rate for Payer: BCBS Trust/PPO |
$252.85
|
| Rate for Payer: BCN Commercial |
$239.37
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cofinity Commercial |
$266.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.80
|
| Rate for Payer: Healthscope Commercial |
$278.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.29
|
| Rate for Payer: Nomi Health Commercial |
$254.00
|
| Rate for Payer: PHP Commercial |
$263.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.34
|
| Rate for Payer: Priority Health HMO/PPO |
$269.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.58
|
| Rate for Payer: UHC Core |
$258.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.31
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17260
|
| Hospital Charge Code |
76100125
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 0.6 TO 1.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17261
|
| Hospital Charge Code |
76100126
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
IP
|
$161.82
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 1.1 TO 2.0 CM
|
Facility
|
OP
|
$161.82
|
|
|
Service Code
|
CPT 17262
|
| Hospital Charge Code |
76100127
|
|
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 MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
OP
|
$532.44
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.45 |
| Max. Negotiated Rate |
$479.20 |
| Rate for Payer: Aetna Commercial |
$452.57
|
| Rate for Payer: Aetna Medicare |
$138.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.39
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$133.11
|
| Rate for Payer: BCBS Trust/PPO |
$437.72
|
| Rate for Payer: BCN Commercial |
$413.97
|
| Rate for Payer: BCN Medicare Advantage |
$133.11
|
| Rate for Payer: Cash Price |
$425.95
|
| Rate for Payer: Cash Price |
$425.95
|
| Rate for Payer: Cofinity Commercial |
$457.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.11
|
| Rate for Payer: Healthscope Commercial |
$479.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.33
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.77
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.57
|
| Rate for Payer: Nomi Health Commercial |
$436.60
|
| Rate for Payer: PACE Senior Care Partners |
$126.45
|
| Rate for Payer: PACE SWMI |
$133.11
|
| Rate for Payer: PHP Commercial |
$452.57
|
| Rate for Payer: PHP Medicare Advantage |
$133.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.09
|
| Rate for Payer: Priority Health HMO/PPO |
$463.22
|
| Rate for Payer: Priority Health Medicare |
$134.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.73
|
| Rate for Payer: Railroad Medicare Medicare |
$133.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.55
|
| Rate for Payer: UHC Core |
$444.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.11
|
| Rate for Payer: UHC Exchange |
$133.11
|
| Rate for Payer: UHC Medicare Advantage |
$133.11
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$133.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.33
|
|
|
HC DESTRUCT MALIGNANT LESION TRUNK, ARMS, LEGS 2.1 TO 3.0 CM
|
Facility
|
IP
|
$532.44
|
|
|
Service Code
|
CPT 17263
|
| Hospital Charge Code |
76100372
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$346.09 |
| Max. Negotiated Rate |
$479.20 |
| Rate for Payer: Aetna Commercial |
$452.57
|
| Rate for Payer: BCBS Trust/PPO |
$434.63
|
| Rate for Payer: BCN Commercial |
$411.47
|
| Rate for Payer: Cash Price |
$425.95
|
| Rate for Payer: Cofinity Commercial |
$457.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.95
|
| Rate for Payer: Healthscope Commercial |
$479.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.57
|
| Rate for Payer: Nomi Health Commercial |
$436.60
|
| Rate for Payer: PHP Commercial |
$452.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$346.09
|
| Rate for Payer: Priority Health HMO/PPO |
$463.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.55
|
| Rate for Payer: UHC Core |
$444.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.33
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
IP
|
$408.88
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$265.77 |
| Max. Negotiated Rate |
$367.99 |
| Rate for Payer: Aetna Commercial |
$347.55
|
| Rate for Payer: BCBS Trust/PPO |
$333.77
|
| Rate for Payer: BCN Commercial |
$315.98
|
| Rate for Payer: Cash Price |
$327.10
|
| Rate for Payer: Cofinity Commercial |
$351.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.10
|
| Rate for Payer: Healthscope Commercial |
$367.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.55
|
| Rate for Payer: Nomi Health Commercial |
$335.28
|
| Rate for Payer: PHP Commercial |
$347.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.77
|
| Rate for Payer: Priority Health HMO/PPO |
$355.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.81
|
| Rate for Payer: UHC Core |
$341.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.66
|
|
|
HC DESTRUCT NEURO AGENT PLANTAR DIGITAL NRV
|
Facility
|
OP
|
$408.88
|
|
|
Service Code
|
CPT 64632
|
| Hospital Charge Code |
36100608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.11 |
| Max. Negotiated Rate |
$367.99 |
| Rate for Payer: Aetna Commercial |
$347.55
|
| Rate for Payer: Aetna Medicare |
$106.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.78
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$102.22
|
| Rate for Payer: BCBS Trust/PPO |
$336.14
|
| Rate for Payer: BCN Commercial |
$317.90
|
| Rate for Payer: BCN Medicare Advantage |
$102.22
|
| Rate for Payer: Cash Price |
$327.10
|
| Rate for Payer: Cash Price |
$327.10
|
| Rate for Payer: Cofinity Commercial |
$351.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.22
|
| Rate for Payer: Healthscope Commercial |
$367.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.66
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.33
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.55
|
| Rate for Payer: Nomi Health Commercial |
$335.28
|
| Rate for Payer: PACE Senior Care Partners |
$97.11
|
| Rate for Payer: PACE SWMI |
$102.22
|
| Rate for Payer: PHP Commercial |
$347.55
|
| Rate for Payer: PHP Medicare Advantage |
$102.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.77
|
| Rate for Payer: Priority Health HMO/PPO |
$355.73
|
| Rate for Payer: Priority Health Medicare |
$103.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.95
|
| Rate for Payer: Railroad Medicare Medicare |
$102.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.81
|
| Rate for Payer: UHC Core |
$341.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.22
|
| Rate for Payer: UHC Exchange |
$102.22
|
| Rate for Payer: UHC Medicare Advantage |
$102.22
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$102.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.66
|
|
